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

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

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.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / mortality
  • Acute Kidney Injury / therapy*
  • Aged
  • COVID-19 / complications*
  • COVID-19 / mortality
  • COVID-19 / therapy*
  • Cohort Studies
  • Continuous Renal Replacement Therapy*
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Respiration, Artificial*
  • Risk Factors
  • SARS-CoV-2 / isolation & purification
  • Treatment Outcome
  • Ventilators, Mechanical