1. "Acute kidney injury in critically ill patients with COVID-19: The AKICOV multicenter study in Catalonia".
- Author
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Sánchez AV, Pérez AN, Pérez-Carrasco M, Sonet MT, Buendia YD, Ballujera PO, López MR, Riera JS, Olmo-Isasmendi A, Torra EV, García-Pumarino MÁ, Villamayor MI, Catalán Ibars RM, Zelaya IO, Chica JP, Anglès CR, Tomasa-Irriguible TM, Serra AB, Casanova EJ, and De Molina FJG
- Subjects
- Humans, Male, Middle Aged, Female, Spain epidemiology, Prospective Studies, Critical Illness, Intensive Care Units, Renal Replacement Therapy, Retrospective Studies, Risk Factors, COVID-19 complications, COVID-19 epidemiology, Acute Kidney Injury epidemiology, Acute Kidney Injury etiology, Acute Kidney Injury therapy
- Abstract
This study describes the incidence, evolution and prognosis of acute kidney injury (AKI) in critical COVID-19 during the first pandemic wave. We performed a prospective, observational, multicenter study of confirmed COVID-19 patients admitted to 19 intensive care units (ICUs) in Catalonia (Spain). Data regarding demographics, comorbidities, drug and medical treatment, physiological and laboratory results, AKI development, need for renal replacement therapy (RRT) and clinical outcomes were collected. Descriptive statistics and logistic regression analysis for AKI development and mortality were used. A total of 1,642 patients were enrolled (mean age 63 (15.95) years, 67.5% male). Mechanical ventilation (MV) was required for 80.8% and 64.4% of these patients, who were in prone position, while 67.7% received vasopressors. AKI at ICU admission was 28.4% and increased to 40.1% during ICU stay. A total of 172 (10.9%) patients required RRT, which represents 27.8% of the patients who developed AKI. AKI was more frequent in severe acute respiratory distress syndrome (ARDS) ARDS patients (68% vs 53.6%, p<0.001) and in MV patients (91.9% vs 77.7%, p<0.001), who required the prone position more frequently (74.8 vs 61%, p<0.001) and developed more infections. ICU and hospital mortality were increased in AKI patients (48.2% vs 17.7% and 51.1% vs 19%, p <0.001) respectively). AKI was an independent factor associated with mortality (IC 1.587-3.190). Mortality was higher in AKI patients who required RRT (55.8% vs 48.2%, p <0.04). Conclusions There is a high incidence of AKI in critically ill patients with COVID-19 disease and it is associated with higher mortality, increased organ failure, nosocomial infections and prolonged ICU stay., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Sánchez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2023
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