Incidence, risk factors and outcome of acute kidney injury in critically ill COVID-19 patients in Tyrol, Austria: a prospective multicenter registry study.
Critical care
Intensive Care Unit
Pandemic
Renal
SARS-CoV-2
Journal
Journal of nephrology
ISSN: 1724-6059
Titre abrégé: J Nephrol
Pays: Italy
ID NLM: 9012268
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
26
03
2023
accepted:
06
08
2023
medline:
11
12
2023
pubmed:
15
10
2023
entrez:
14
10
2023
Statut:
ppublish
Résumé
Acute kidney injury is a frequent complication in critically ill patients with and without COVID-19. The aim of this study was to evaluate the incidence of, and risk factors for, acute kidney injury and its effect on clinical outcomes of critically ill COVID-19 patients in Tyrol, Austria. This multicenter prospective registry study included adult patients with a SARS-CoV-2 infection confirmed by polymerase chain reaction, who were treated in one of the 12 dedicated intensive care units during the COVID-19 pandemic from February 2020 until May 2022. In total, 1042 patients were included during the study period. The median age of the overall cohort was 66 years. Of the included patients, 267 (26%) developed acute kidney injury during their intensive care unit stay. In total, 12.3% (n = 126) required renal replacement therapy with a median duration of 9 (IQR 3-18) days. In patients with acute kidney injury the rate of invasive mechanical ventilation was significantly higher with 85% (n = 227) compared to 41% (n = 312) in the no acute kidney injury group (p < 0.001). The most important risk factors for acute kidney injury were invasive mechanical ventilation (OR = 4.19, p < 0.001), vasopressor use (OR = 3.17, p < 0.001) and chronic kidney disease (OR = 2.30, p < 0.001) in a multivariable logistic regression analysis. Hospital and intensive care unit mortality were significantly higher in patients with acute kidney injury compared to patients without acute kidney injury (Hospital mortality: 52.1% vs. 17.2%, p < 0.001, ICU-mortality: 47.2% vs. 14.7%, p < 0.001). As in non-COVID-19 patients, acute kidney injury is clearly associated with increased mortality in critically ill COVID-19 patients. Among known risk factors, invasive mechanical ventilation has been identified as an independent and strong predictor of acute kidney injury.
Identifiants
pubmed: 37837501
doi: 10.1007/s40620-023-01760-3
pii: 10.1007/s40620-023-01760-3
pmc: PMC10703973
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2531-2540Informations de copyright
© 2023. The Author(s).
Références
Nefrologia (Engl Ed). 2022 Jul-Aug;42(4):404-414
pubmed: 36460430
Ann Intensive Care. 2021 Aug 6;11(1):123
pubmed: 34357478
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
PLoS One. 2021 Feb 8;16(2):e0246595
pubmed: 33556150
Wien Klin Wochenschr. 2020 Nov;132(21-22):653-663
pubmed: 33170333
Clin J Am Soc Nephrol. 2020 Oct 7;15(10):1394-1402
pubmed: 32963018
Crit Care. 2020 Jun 18;24(1):356
pubmed: 32552872
Wien Klin Wochenschr. 2021 Dec;133(23-24):1237-1247
pubmed: 34661740
Crit Care. 2018 Aug 3;22(1):188
pubmed: 30075798
PLoS One. 2021 Feb 11;16(2):e0246318
pubmed: 33571301
J Investig Med. 2020 Oct;68(7):1261-1270
pubmed: 32655013
Intensive Care Med. 2005 Oct;31(10):1336-44
pubmed: 16132893
Ann Med. 2020 Nov;52(7):345-353
pubmed: 32643418
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Clin J Am Soc Nephrol. 2010 Sep;5(9):1690-5
pubmed: 20688882
N Engl J Med. 2021 Feb 25;384(8):693-704
pubmed: 32678530
Lancet. 2020 Aug 1;396(10247):320-332
pubmed: 32682491
Lancet. 2020 May 2;395(10234):1417-1418
pubmed: 32325026
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Crit Care. 2022 Jul 25;26(1):225
pubmed: 35879765
J Am Soc Nephrol. 2021 Jan;32(1):151-160
pubmed: 32883700
Crit Care Med. 2009 May;37(5):1649-54
pubmed: 19325482
Intensive Care Med. 2015 Aug;41(8):1411-23
pubmed: 26162677
Clin J Am Soc Nephrol. 2014 Aug 7;9(8):1347-53
pubmed: 24875195
Kidney Int. 2020 May;97(5):829-838
pubmed: 32247631
Kidney Int Rep. 2020 Jun 25;5(8):1149-1160
pubmed: 32775814
Kidney Int Rep. 2021 Apr;6(4):916-927
pubmed: 33558853
Eur Respir Rev. 2021 Oct 20;30(162):
pubmed: 34670808
Nephron Clin Pract. 2012;120(4):c179-84
pubmed: 22890468
Front Med (Lausanne). 2022 Mar 18;9:799298
pubmed: 35372447
N Engl J Med. 2020 Oct 8;383(15):1483-1488
pubmed: 32706956
Stat Med. 1995 Oct 15;14(19):2161-72
pubmed: 8552894
Med Klin Intensivmed Notfmed. 2022 Jun;117(5):342-348
pubmed: 35476144
Intensive Care Med. 2009 Oct;35(10):1692-702
pubmed: 19547955
Intensive Care Med. 2013 Mar;39(3):420-8
pubmed: 23291734
Intensive Care Med. 2020 Apr;46(4):654-672
pubmed: 31820034
Intensive Care Med. 2005 Oct;31(10):1345-55
pubmed: 16132892
Blood Purif. 2021;50(6):767-771
pubmed: 33412548
JAMA Intern Med. 2020 Nov 1;180(11):1436-1447
pubmed: 32667668
J Clin Monit Comput. 2022 Feb;36(1):161-167
pubmed: 33385260
J Am Soc Nephrol. 2020 Sep;31(9):2145-2157
pubmed: 32669322
Crit Care. 2013 May 27;17(3):R98
pubmed: 23710662
Int J Mol Sci. 2022 Feb 17;23(4):
pubmed: 35216358
Nat Rev Nephrol. 2020 Dec;16(12):703-704
pubmed: 32929200
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
Clin Res Cardiol. 2018 Oct;107(10):937-944
pubmed: 29744618
Kidney Int. 2020 Jul;98(1):209-218
pubmed: 32416116
Clin Kidney J. 2020 Sep 02;13(4):550-563
pubmed: 32897278
JAMA. 2020 Jun 9;323(22):2329-2330
pubmed: 32329799
Kidney Med. 2021 Jan-Feb;3(1):83-98.e1
pubmed: 33319190
Am J Kidney Dis. 2015 Oct;66(4):591-601
pubmed: 25943717