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Observational Study
. 2021;50(1):102-109.
doi: 10.1159/000508657. Epub 2020 Jul 13.

Prevalence, Characteristics, Risk Factors, and Outcomes of Invasively Ventilated COVID-19 Patients with Acute Kidney Injury and Renal Replacement Therapy

Evgeny V Fominskiy  1 , Anna Mara Scandroglio  1 , Giacomo Monti  1 , Maria Grazia Calabrò  1 , Giovanni Landoni  2   3 , Antonio Dell'Acqua  1 , Luigi Beretta  1 , Elena Moizo  1 , Alfredo Ravizza  1 , Fabrizio Monaco  1 , Corrado Campochiaro  4 , Marina Pieri  1 , Maria Luisa Azzolini  1 , Giovanni Borghi  1 , Martina Crivellari  1 , Caterina Conte  5   6 , Cristina Mattioli  1 , Paolo Silvani  1 , Milena Mucci  1 , Stefano Turi  1 , Stefano Tentori  7 , Martina Baiardo Redaelli  1 , Marianna Sartorelli  1 , Piera Angelillo  8 , Alessandro Belletti  1 , Pasquale Nardelli  1 , Francesco Giuseppe Nisi  1 , Gabriele Valsecchi  1 , Cristina Barberio  1 , Fabio Ciceri  5   8 , Ary Serpa Neto  9   10   11 , Lorenzo Dagna  5   4 , Rinaldo Bellomo  9   12   13   14   11 , Alberto Zangrillo  1   5 ; COVID-BioB Study Group
Affiliations
Observational Study

Prevalence, Characteristics, Risk Factors, and Outcomes of Invasively Ventilated COVID-19 Patients with Acute Kidney Injury and Renal Replacement Therapy

Evgeny V Fominskiy et al. Blood Purif. 2021.

Abstract

Background: There is no information on acute kidney injury (AKI) and continuous renal replacement therapy (CRRT) among invasively ventilated coronavirus disease 2019 (COVID-19) patients in Western healthcare systems.

Objective: To study the prevalence, characteristics, risk factors and outcome of AKI and CRRT among invasively ventilated COVID-19 patients.

Methods: Observational study in a tertiary care hospital in Milan, Italy.

Results: Among 99 patients, 72 (75.0%) developed AKI and 17 (17.7%) received CRRT. Most of the patients developed stage 1 AKI (33 [45.8%]), while 15 (20.8%) developed stage 2 AKI and 24 (33.4%) a stage 3 AKI. Patients who developed AKI or needed CRRT at latest follow-up were older, and among CRRT treated patients a greater proportion had preexisting CKD. Hospital mortality was 38.9% for AKI and 52.9% for CRRT patients.

Conclusions: Among invasively ventilated COVID-19 patients, AKI is very common and CRRT use is common. Both carry a high risk of in-hospital mortality.

Keywords: Acute kidney injury; Coronavirus; Coronavirus disease 2019; Critical care; Renal replacement therapy.

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Conflict of interest statement

The authors have no conflict of interest in relation to this study. They also have no other nonfinancial relationship which may influence the writing of the manuscript. Other forms of support which took place in the 3 preceding years and that have no relevance to the study are listed below.

Prof. Lorenzo Dagna received consultation honoraria from Roche, Sanofi-Genzyme, and SOBI outside of the submitted work. Prof. Ary Serpa Neto received speaking fees from Dräger outside of the submitted work.

Figures

Fig. 1
Fig. 1
Cumulative incidence function of hospital discharge and extubation according to development of AKI. Cumulative incidence function considering death before the event as competing risk. AKI, acute kidney infection.
Fig. 2
Fig. 2
Cumulative incidence function of hospital discharge and extubation according to need of RRT. Cumulative incidence function considering death before the event as competing risk. RRT, renal replacement therapy.
See this image and copyright information in PMC

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