The incidence of acute kidney injury and its association with mortality in patients diagnosed with<scp>COVID</scp>‐19 followed up in intensive care unit

Bayrakci, Nergiz; Özkan, Gülsüm; Şakacı, Murat; Sedef, Samet; Erdem, İlknur; Tuna, Nazan; Mutlu, Levent; Yıldırım, İlker; Kiraz, Nuri̇; Erdal, Berna; Gelgeç, Ebru; Erer, Aysen; Saraç, Ömürhan; Yavuz, Ahmet; Dolap, Uysal; Hayri, Uluğ Bey; Kocadelioğlu, İnci; Batmaz, Emrah

doi:10.1111/1744-9987.13790

Cited by 7 publications

(8 citation statements)

References 38 publications

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“…The use of CRRT in our critical patients with COVID-19 was consistent with previous epidemiological studies in which the use of CRRT was required in approximately 44% of patients [16]. Many studies reported that AKI is a common complication in critical COVID-19 cases and occurred in 25-76% of cases, with 5-44% of them requiring CRRT [32,33]. About 35-50.9% of patients with AKI in the ICU associated with COVID-19 pneumonia required CRRT in some studies from the United States [9,15].…”

Section: Discussionsupporting

confidence: 88%

Acute kidney injury in Coronavirus disease-19 related pneumonia in the intensive care unit: a retrospective multicenter study, Saudi Arabia

Eldaboosy

Awad²,

Farouk³

et al. 2023

Multidis Res Med

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Background: Acute kidney injury (AKI) poses a significant morbidity and mortality risk to critically ill COVID-19 patients. The aim of this study was to investigate the incidence, predictors, and outcomes of AKI in patients admitted to the intensive care unit with critically ill COVID-19 pneumonia.Methods: A multicenter retrospective study in Saudi Arabia of adult patients aged at least 18 years diagnosed with COVID-19 pneumonia and admitted to the intensive care unit between May 2020 and May 2021. The occurrence of acute kidney injury and associated risk factors, the need for continuous renal replacement therapy, and the outcome were reported.Results: The study included 340 patients admitted to the ICU with COVID-19. Their mean age was 66.7±13.4 years, ranging from 49 to 84 years, and most of them were men (63.8%). The most common concomitant diseases were hypertension (71.5%), diabetes (62.4%), IHD (37.6%), CKD (20%), heart failure (19.4%), and 81.2% suffered from ARDS. AKI occurred in 60.3% of patients, 38% were stage 1, 16.6% were stage 2, and 45.4% were stage 3. Approximately 39% of patients required continuous renal replacement therapy (CRRT), of which 76.2% were stage 3, which was significantly higher than the other stages (p<0.001). AKI patients suffered significantly from asthma and had lower levels of C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), and blood urea nitrogen (BUN) and higher creatinine levels than patients without AKI (p<0.05 all). The overall mortality rate was 39.4%, and the mortality rate was significantly higher in patients with AKI than in patients without AKI (48.3% versus 25.9%; p<0.001).Conclusion: AKI is common in adults admitted to the intensive care unit with COVID-19 and is associated with an increased risk of death. Early detection of AKI and appropriate treatment can positively impact COVID-19 the outcome. CRRT is the preferred dialysis method in critically ill ICU patients with AKI.

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Section: Discussionsupporting

confidence: 88%

Acute kidney injury in Coronavirus disease-19 related pneumonia in the intensive care unit: a retrospective multicenter study, Saudi Arabia

Eldaboosy

Awad²,

Farouk³

et al. 2023

Multidis Res Med

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“…Male gender and hypertension were independently associated with AKI development. These results were expected as these variables were well-known risk factors for AKI in COVID-19 population [3, 25, 26].…”

Section: Discussionmentioning

confidence: 71%

The Effect of Positive Pressure Ventilation on Acute Kidney Injury in COVID-19 Patients with Acute Respiratory Distress Syndrome: An Observational Study

Zacchetti,

Brivio,

Mezzapesa

et al. 2024

Blood Purif

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Introduction: Acute kidney injury (AKI) is frequent in critically ill COVID-19 patients and is associated with a higher mortality risk. By increasing intrathoracic pressure, positive pressure ventilation (PPV) may reduce renal perfusion pressure by reducing venous return to the heart or by increasing renal venous congestion. This study’s aim was to evaluate the association between AKI and hemodynamic and ventilatory parameters in COVID-19 patients with ARDS. Methods: this is a single-centre retrospective observational study. Consecutive patients diagnosed with COVID-19 who met ARDS criteria and required invasive mechanical ventilation were enrolled. The relationship between respiratory and hemodynamic parameters influenced by positive pressure ventilation and AKI development was evaluated. AKI was defined according to KDIGO criteria. AKI recovery was evaluated a month after ICU admission and patients were classified as “recovered”, if serum creatinine (sCr) value returned to baseline, or as having “acute kidney disease” (AKD), if criteria for AKI stage 1 or greater persisted. The 6-month all-cause mortality was collected. Results: 144 patients were included in the analysis. AKI occurred in 69 (48%) patients and 26 (18%) required Renal Replacement Therapy (RRT). In a multivariate logistic regression analysis, sex, hypertension, cumulative dose of furosemide, fluid balance, and plateau pressure were independently associated with AKI. Mortality at 6 months was 50% in the AKI group and 32% in the non-AKI group (p=0.03). Among 36 patients who developed AKI and were discharged alive from the hospital, 56% had a full renal recovery after a month, while 14%, 6% and 14% were classified as having an Acute Kidney Disease (AKD) of stage 0, 2 and 3, respectively. Conclusions: in our cohort, AKI was independently associated with multiple variables, including high plateau pressure, suggesting a possible role of positive pressure ventilation on AKI development. Further studies are needed to clarify the role of mechanical ventilation on renal function.

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“…Acute kidney injury (AKI) is a common complication of COVID-19, affecting 25-77% of patients admitted to an intensive care unit (ICU) and associated with major challenges for the healthcare team [4,[6][7][8][9][10]. Between 5 and 44% of patients receive kidney replacement therapy (KRT) [11][12][13][14][15][16]. We hypothesised that the incidence of COVID-19 associated AKI and KRT rates had declined since the beginning of the pandemic [17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Changing epidemiology of acute kidney injury in critically ill patients with COVID-19: a prospective cohort

Lumlertgul

Baker

Pearson

et al. 2022

Ann. Intensive Care

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Background Acute kidney injury (AKI) is common in critically ill patients with coronavirus disease-19 (COVID-19). We aimed to explore the changes in AKI epidemiology between the first and the second COVID wave in the United Kingdom (UK). Methods This was an observational study of critically ill adult patients with COVID-19 in an expanded tertiary care intensive care unit (ICU) in London, UK. Baseline characteristics, organ support, COVID-19 treatments, and patient and kidney outcomes up to 90 days after discharge from hospital were compared. Results A total of 772 patients were included in the final analysis (68% male, mean age 56 ± 13.6). Compared with wave 1, patients in wave 2 were older, had higher body mass index and clinical frailty score, but lower baseline serum creatinine and C-reactive protein (CRP). The proportion of patients receiving invasive mechanical ventilation (MV) on ICU admission was lower in wave 2 (61% vs 80%; p < 0.001). AKI incidence within 14 days of ICU admission was 76% in wave 1 and 51% in wave 2 (p < 0.001); in wave 1, 32% received KRT compared with 13% in wave 2 (p < 0.001). Patients in wave 2 had significantly lower daily cumulative fluid balance (FB) than in wave 1. Fewer patients were dialysis dependent at 90 days in wave 2 (1% vs. 4%; p < 0.001). Conclusions In critically ill adult patients admitted to ICU with COVID-19, the risk of AKI and receipt of KRT significantly declined in the second wave. The trend was associated with less MV, lower PEEP and lower cumulative FB. Trial registration: NCT04445259.

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The incidence of acute kidney injury and its association with mortality in patients diagnosed withCOVID‐19 followed up in intensive care unit

Cited by 7 publications

References 38 publications

Acute kidney injury in Coronavirus disease-19 related pneumonia in the intensive care unit: a retrospective multicenter study, Saudi Arabia

Acute kidney injury in Coronavirus disease-19 related pneumonia in the intensive care unit: a retrospective multicenter study, Saudi Arabia

The Effect of Positive Pressure Ventilation on Acute Kidney Injury in COVID-19 Patients with Acute Respiratory Distress Syndrome: An Observational Study

Changing epidemiology of acute kidney injury in critically ill patients with COVID-19: a prospective cohort

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