Impact of CRRT on the outcome of critically ill Covid-19 infected patients with acute kidney injury. A retrospective observational cross-sectional study

Abstract

Background: Numerous studies have postulated that Acute kidney injury in COVID-19 patients is significantly associated with an increased mortality (1,2). Continuous renal replacement therapy (CRRT) is the preferred modality of dialytic therapy in hemodynamically unstable COVID-19 patients who develop an acute renal failure. It is evident there is diversity in the number of patients who recover or survive after use of CRRT in these cases (3). Clearly, the decision to initiate CRRT in patients with COVID-19 acute kidney injury (AKI) should be individualized. Some earlier studies have reported that CRRT was associated with improved outcomes, including reduced intensive care unit (ICU) and hospital mortality, shorter duration of mechanical ventilation, and shorter ICU stays (8). On the other hand, others have claimed that CRRT improves renal function, but does not have impact on overall mortality (4). Objectives: Our aim was to study the association between the development of an AKI in COVID-19 patients and ICU stay as a primary endpoint and to study the influence of CRRT on the recovery of the renal function as secondary endpoints. Study Population Our study population had included all adult patients who were above 18 years old and were admitted to our ICU on the background of a laboratory confirmed COVID-19 infection who had developed an AKI during the ICU course according to AKIN criteria. Our included population should have had no previous history of chronic kidney disease or renal replacement therapy. Methods: Our study is a retrospective cross-sectional study, that was conducted during the period from June 2021 till the end of June 2022.All methods were run according to rules and regulations ethical, administrative, and scientific. Ethical and administrative approvals were taken from the assigned authority Research Ethical Committee Emirates Health Services (REC). Ethical committee approval is joined already. Informed consent from the legal guardians for all patients was taken already. All methods were performed in accordance in accordance with the relevant guidelines and regulations. Statistical analysis: All data have been collected and analyzed by the investigators using Microsoft Excel and Statistical Package for the Social Sciences (SPSS) software version 22. Results: A total of 108 COVID-19 patients with AKI were admitted to our ICU during the study period. We have identified a significantly increased ICU stay in CRRT group (Median 16 days) as compared to non-CRRT group (Median 4.4 days), P value was 0.00. Discussion: We have identified a significantly increased ICU stay in CRRT group (Median 16 days) if compared to non-CRRT group (Median 4.4 days), P value 0.00. Conclusion: We’ve concluded that the CRRT in Covid-19 patients with AKI is associated with increased ICU stay, even if the kidney function is improved