Long-term outcome of COVID-19 patients with acute kidney injury requiring kidney replacement therapy.
Acute kidney injury
COVID-19
Kidney recovery
Kidney replacement therapy
Mortality
Journal
Journal of anesthesia, analgesia and critical care
ISSN: 2731-3786
Titre abrégé: J Anesth Analg Crit Care
Pays: England
ID NLM: 9918591885906676
Informations de publication
Date de publication:
09 May 2024
09 May 2024
Historique:
received:
22
01
2024
accepted:
15
04
2024
medline:
10
5
2024
pubmed:
10
5
2024
entrez:
9
5
2024
Statut:
epublish
Résumé
Limited data existed on the burden of coronavirus disease 2019 (COVID-19) renal complications and the outcomes of the most critical patients who required kidney replacement therapy (KRT) during intensive care unit (ICU) stay. We aimed to describe mortality and renal function at 90 days in patients admitted for COVID-19 and KRT. A retrospective cohort study of critically ill patients admitted for COVID-19 and requiring KRT from March 2020 to January 2022 was conducted in an Italian ICU from a tertiary care hospital. Primary outcome was mortality at 90 days and secondary outcome was kidney function at 90 days. A cohort of 45 patients was analyzed. Mortality was 60% during ICU stay and increased from 64% at the time of hospital discharge to 71% at 90 days. Among 90-day survivors, 31% required dialysis, 38% recovered incompletely, and 31% completely recovered renal function. The probability of being alive and dialysis-free at 3 months was 22%. Critically ill patients with COVID-19 disease requiring KRT during ICU stay had elevated mortality rate at 90 days, with low probability of being alive and dialysis-free at 3 months. However, a non-negligible number of patients completely recovered renal function.
Sections du résumé
BACKGROUND
BACKGROUND
Limited data existed on the burden of coronavirus disease 2019 (COVID-19) renal complications and the outcomes of the most critical patients who required kidney replacement therapy (KRT) during intensive care unit (ICU) stay. We aimed to describe mortality and renal function at 90 days in patients admitted for COVID-19 and KRT.
METHODS
METHODS
A retrospective cohort study of critically ill patients admitted for COVID-19 and requiring KRT from March 2020 to January 2022 was conducted in an Italian ICU from a tertiary care hospital. Primary outcome was mortality at 90 days and secondary outcome was kidney function at 90 days.
RESULTS
RESULTS
A cohort of 45 patients was analyzed. Mortality was 60% during ICU stay and increased from 64% at the time of hospital discharge to 71% at 90 days. Among 90-day survivors, 31% required dialysis, 38% recovered incompletely, and 31% completely recovered renal function. The probability of being alive and dialysis-free at 3 months was 22%.
CONCLUSIONS
CONCLUSIONS
Critically ill patients with COVID-19 disease requiring KRT during ICU stay had elevated mortality rate at 90 days, with low probability of being alive and dialysis-free at 3 months. However, a non-negligible number of patients completely recovered renal function.
Identifiants
pubmed: 38725050
doi: 10.1186/s44158-024-00163-5
pii: 10.1186/s44158-024-00163-5
doi:
Types de publication
Journal Article
Langues
eng
Pagination
32Informations de copyright
© 2024. The Author(s).
Références
Hirsch JS, Ng JH, Ross DW, Sharma P, Shah HH, Barnett RL et al (2020) Acute kidney injury in patients hospitalized with COVID-19. Kidney Int 98(1):209–218
doi: 10.1016/j.kint.2020.05.006
pubmed: 32416116
pmcid: 7229463
Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L et al (2020) Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 97(5):829–838
doi: 10.1016/j.kint.2020.03.005
pubmed: 32247631
pmcid: 7110296
Pasin L, Sella N, Correale C, Boscolo A, Rosi P, Saia M et al (2020) Regional COVID-19 network for coordination of SARS-CoV-2 outbreak in Veneto, Italy. J Cardiothorac Vasc Anesth 34(9):2341–2345
doi: 10.1053/j.jvca.2020.05.005
pubmed: 32425461
pmcid: 7228700
Clinical Practice Guidelines for Acute Kidney Injury (2012) Kidney International Supplements. 2(1):1. http://www.kdigo.org/clinicalpracticeguidelines/AKI.php
Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Acute Disease Quality Initiative Workgroup 16 et al (2017) Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nat Rev Nephrol 13(4):241–57
doi: 10.1038/nrneph.2017.2
pubmed: 28239173
Neyra JA, Ortiz-Soriano V, Liu LJ, Smith TD, Li X, Xie D et al (2023) Prediction of mortality and major adverse kidney events in critically ill patients with acute kidney injury. Am J Kidney Dis 81(1):36–47
doi: 10.1053/j.ajkd.2022.06.004
pubmed: 35868537
Bezerra R, Teles F, Mendonca PB, Damte T, Likaka A, Ferrer-Miranda E et al (2021) Outcomes of critically ill patients with acute kidney injury in COVID-19 infection: an observational study. Ren Fail 43(1):911–918
doi: 10.1080/0886022X.2021.1933530
pubmed: 34057014
pmcid: 8168780
Lumlertgul N, Pirondini L, Cooney E, Kok W, Gregson J, Camporota L et al (2021) Acute kidney injury prevalence, progression and long-term outcomes in critically ill patients with COVID-19: a cohort study. Ann Intensive Care 11(1):123
doi: 10.1186/s13613-021-00914-5
pubmed: 34357478
pmcid: 8343342
Sánchez ADLV, Pérez AN, Pérez-Carrasco M, Sonet MT, Buendia YD, Ballujera PO et al (2023) Acute kidney injury in critically ill patients with COVID–19: the AKICOV multicenter study in Catalonia. PLoS One 18(4):e0284248 Camps J, editor
doi: 10.1371/journal.pone.0284248
pubmed: 37058544
pmcid: 10104297
Wilbers TJ, Koning MV (2020) Renal replacement therapy in critically ill patients with COVID-19: a retrospective study investigating mortality, renal recovery and filter lifetime. J Crit Care 60:103–105
doi: 10.1016/j.jcrc.2020.07.025
pubmed: 32795841
pmcid: 7391167
Thakkar J, Chand S, Aboodi MS, Gone AR, Alahiri E, Schecter DE et al (2020) Characteristics, outcomes and 60-day hospital mortality of ICU patients with COVID-19 and acute kidney injury. Kidney360 1(12):1339–44
doi: 10.34067/KID.0004282020
pubmed: 35372894
pmcid: 8815522
Doher MP, De Carvalho Torres FR, Scherer PF, Matsui TN, Ammirati AL, Da Silva Caldin B et al (2021) Acute kidney injury and renal replacement therapy in critically ill COVID-19 patients: risk factors and outcomes: a single-center experience in Brazil. Blood Purif 50(4–5):520–30
doi: 10.1159/000513425
pubmed: 33341806
Stevens JS, King KL, Robbins-Juarez SY, Khairallah P, Toma K, Alvarado Verduzco H et al (2020) High rate of renal recovery in survivors of COVID-19 associated acute renal failure requiring renal replacement therapy. PLoS One 15(12):e0244131 Dal Pizzol F, editor
doi: 10.1371/journal.pone.0244131
pubmed: 33370368
pmcid: 7769434
Eriksson KE, Campoccia-Jalde F, Rysz S, Rimes-Stigare C (2021) Continuous renal replacement therapy in intensive care patients with COVID-19; survival and renal recovery. J Crit Care 64:125–130
doi: 10.1016/j.jcrc.2021.04.002
pubmed: 33878517
pmcid: 8052481
Gupta S, Coca SG, Chan L, Melamed ML, Brenner SK, Hayek SS et al (2021) AKI Treated with renal replacement therapy in critically ill patients with COVID-19. JASN 32(1):161–176
doi: 10.1681/ASN.2020060897
pubmed: 33067383
El Mouhayyar C, Dewald J, Cabrales J, Tighiouart H, Moraco AH, Jaber BL et al (2022) Factors associated with severity of acute kidney injury and adverse outcomes in critically ill patients with COVID-19. Nephron 146(6):584–592
doi: 10.1159/000524657
pubmed: 35675790
Samaan F, De Paula Carneiro E, De Lima Souza FBG, Mendes LFC, Rossi PRG, Freitas RAP et al (2022) COVID-19-associated acute kidney injury patients treated with renal replacement therapy in the intensive care unit: a multicenter study in São Paulo, Brazil. PLoS One 17(1):e0261958 Bhimma R, editor
doi: 10.1371/journal.pone.0261958
pubmed: 35030179
pmcid: 8759670
Anandh U, Noorin A, Kazmi SKS, Bannur S, Shah SSA, Farooq M et al (2022) Acute kidney injury in critically ill COVID-19 infected patients requiring dialysis: experience from India and Pakistan. BMC Nephrol 23(1):308
doi: 10.1186/s12882-022-02931-3
pubmed: 36076183
pmcid: 9452278
Ssentongo P, Ssentongo AE, Heilbrunn ES, Ba DM, Chinchilli VM (2020) Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: a systematic review and meta-analysis. PLoS One 15(8):e0238215 Hirst JA, editor
doi: 10.1371/journal.pone.0238215
pubmed: 32845926
pmcid: 7449476
Melero R, Mijaylova A, Rodriguez-Benitez P, Macıas N, Aragoncillo I, Rodriguez-Ferrero ML et al (2011) Renal long-term outcome of critically ill COVID-19 patients with acute kidney failure and continuous renal replacement therapy. Clin Kidney J 14(11):2449–2450
Ng JH, Hirsch JS, Hazzan A, Wanchoo R, Shah HH, Malieckal DA et al (2021) Outcomes among patients hospitalized with COVID-19 and acute kidney injury. Am J Kidney Dis 77(2):204-215.e1
doi: 10.1053/j.ajkd.2020.09.002
pubmed: 32961245
Hsu CM, Gupta S, Tighiouart H, Goyal N, Faugno AJ, Tariq A et al (2022) Kidney Recovery and death in critically ill patients with COVID-19–associated acute kidney injury treated with dialysis: the STOP-COVID cohort study. Am J Kidney Dis 79(3):404-416.e1
doi: 10.1053/j.ajkd.2021.11.004
pubmed: 34871701
Chand S, Kapoor S, Naqvi A, Thakkar J, Fazzari MJ, Orsi D et al (2022) Long-term follow up of renal and other acute organ failure in survivors of critical illness due to Covid-19. J Intensive Care Med 37(6):736–742
doi: 10.1177/08850666211062582
pubmed: 34918990
pmcid: 9064678