The incidence, risk factors and prognosis of acute kidney injury in severe and critically ill patients with COVID-19 in mainland China: a retrospective study

Sang, Ling; Chen, Sibei; Zheng, Xia; Guan, Wei‐Jie; Zhang, Zhihui; Liang, Wenhua; Ming, Zhong; Jiang, Li; Pan, Chun; Zhang, Wei; Xia, Jiaan; Chen, Nanshan; Wu, Wenjuan; Wu, Haishan; Xu, Yonghao; Liu, Xuesong; Liu, Xiaoqing; He, Jianxing; Li, Shiyue; Zhang, Dingyu; Zhong, Nanshan; Li, Yimin

doi:10.21203/rs.3.rs-50431/v1

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…Possible explanations are younger age and relatively low CCI and CFS. Other reasons may include factors [11,18,[41][42][43][44][45][46]. Our low dialysis dependence rates perhaps may be due to a relatively low proportion of patients with pre-existing CKD.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury prevalence, progression and long-term outcomes in critically ill patients with COVID-19: a cohort study

Lumlertgul

Pirondini

Cooney

et al. 2021

Ann. Intensive Care

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Background There are limited data on acute kidney injury (AKI) progression and long-term outcomes in critically ill patients with coronavirus disease-19 (COVID-19). We aimed to describe the prevalence and risk factors for development of AKI, its subsequent clinical course and AKI progression, as well as renal recovery or dialysis dependence and survival in this group of patients. Methods This was a retrospective observational study in an expanded tertiary care intensive care unit in London, United Kingdom. Critically ill patients admitted to ICU between 1st March 2020 and 31st July 2020 with confirmed SARS-COV2 infection were included. Analysis of baseline characteristics, organ support, COVID-19 associated therapies and their association with mortality and outcomes at 90 days was performed. Results Of 313 patients (70% male, mean age 54.5 ± 13.9 years), 240 (76.7%) developed AKI within 14 days after ICU admission: 63 (20.1%) stage 1, 41 (13.1%) stage 2, 136 (43.5%) stage 3. 113 (36.1%) patients presented with AKI on ICU admission. Progression to AKI stage 2/3 occurred in 36%. Risk factors for AKI progression were mechanical ventilation [HR (hazard ratio) 4.11; 95% confidence interval (CI) 1.61–10.49] and positive fluid balance [HR 1.21 (95% CI 1.11–1.31)], while steroid therapy was associated with a reduction in AKI progression (HR 0.73 [95% CI 0.55–0.97]). Kidney replacement therapy (KRT) was initiated in 31.9%. AKI patients had a higher 90-day mortality than non-AKI patients (34% vs. 14%; p < 0.001). Dialysis dependence was 5% at hospital discharge and 4% at 90 days. Renal recovery was identified in 81.6% of survivors at discharge and in 90.9% at 90 days. At 3 months, 16% of all AKI survivors had chronic kidney disease (CKD); among those without renal recovery, the CKD incidence was 44%. Conclusions During the first COVID-19 wave, AKI was highly prevalent among severely ill COVID-19 patients with a third progressing to severe AKI requiring KRT. The risk of developing CKD was high. This study identifies factors modifying AKI progression, including a potentially protective effect of steroid therapy. Recognition of risk factors and monitoring of renal function post-discharge might help guide future practice and follow-up management strategies. Trial registration NCT04445259

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Section: Discussionmentioning

confidence: 99%

Acute kidney injury prevalence, progression and long-term outcomes in critically ill patients with COVID-19: a cohort study

Lumlertgul

Pirondini

Cooney

et al. 2021

Ann. Intensive Care

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Acute kidney injury in adult patients with COVID-19: an integrative review

Pereira,

Almeida,

Aguiar

et al. 2024

Acta Paul Enferm

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Objective: To identify the frequency of acute kidney injury (AKI) in patients hospitalized with COVID-19, associated characteristics, mortality and lethality. Methods: Integrative review carried out in the databases CINAHL, Embase, LILACS, Livivo, PubMed, SCOPUS, Web of Science and in the grey literature (Google Scholar) on January 12, 2022. Articles were included in English, Spanish and Portuguese, published from November 2019 to January 2022, in hospitalized patients over 18 years old with COVID-19 and AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The selected studies were read in full for extraction, interpretation, synthesis and categorization according to the level of evidence. Results: A total of 699 articles were found and 45 included. Older age, male gender, hypertension, chronic kidney disease, mechanical ventilation, increased C-reactive protein, use of vasoactive drugs and certain classes of antihypertensives were associated with AKI. AKI is related to a higher frequency of mortality. AKI occurred in 30% of patients hospitalized with COVID-19. The mortality rate from AKI was 5% and the case fatality rate was 18%. Conclusion: These results highlight the relevance of AKI as a significant complication of COVID-19 and suggest that more careful and early control of associated factors could potentially reduce mortality and lethality. It is crucial to intensify research in this field to better clarify the mechanisms involved in kidney injury in COVID-19 patients, as well as to identify more effective therapeutic strategies for its prevention and treatment in this context.

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Covid-19-induced acute kidney injury in critical patients: what does the literature say / Lesão aguda induzida pela covid-19 em pacientes críticos: o que diz a literatura?

Costa

Muniz

Ribeiro

2023

RPCF

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Objetivo: identificar por meio da literatura a relação entre lesão renal aguda (LRA) e COVID-19, no paciente crítico. Método: revisão integrativa da literatura, com seleção dos artigos publicados entre 2020 e 2021 nas bases de dados da Biblioteca Virtual da Saúde: LILACS, SCIELO, PUBMED. Por meio dos descritores “Lesão Renal Aguda” AND “Coronavírus-19” AND “Unidade de Terapia Intensiva”. Resultados: o estudo foi composto por um recorte de 12 publicações. Os estudos em geral apontam que a LRA no contexto da COVID-19, é de causa multifatorial, entretanto não há consenso sobre essa afirmativa, uma vez que alguns estudos apontam que a COVID-19 contribui diretamente para novos casos de LRA em pacientes críticos devido à cascata de citocinas presente na patologia, o que não foi confirmado por todos os estudos. Conclusão: esta revisão evidenciou que a LRA é uma complicação presente em pacientes críticos com Covid-19. Os estudos encontrados demonstram que o assunto ainda precisa melhor explorado para que a relação entre o COVID-19 e a LRA seja definitivamente esclarecida.

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The incidence, risk factors and prognosis of acute kidney injury in severe and critically ill patients with COVID-19 in mainland China: a retrospective study

Cited by 3 publications

References 24 publications

Acute kidney injury prevalence, progression and long-term outcomes in critically ill patients with COVID-19: a cohort study

Acute kidney injury prevalence, progression and long-term outcomes in critically ill patients with COVID-19: a cohort study

Acute kidney injury in adult patients with COVID-19: an integrative review

Covid-19-induced acute kidney injury in critical patients: what does the literature say / Lesão aguda induzida pela covid-19 em pacientes críticos: o que diz a literatura?

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