Acute renal failure, COVID-19 and deaths, worrying rates in intensive care units: a cross-sectional study

Sao Paulo Med J. 2024 Aug 9;142(6):e2023150. doi: 10.1590/1516-3180.2023.0150.R1.13052024. eCollection 2024.

Abstract

Background: Acute kidney failure is a serious consequence of coronavirus disease 2019 (COVID-19).

Objectives: To identify the prevalence of COVID-19, kidney failure, frequency of death, and associated factors in patients receiving intensive care.

Design and setting: Analytical cross-sectional study conducted in the intensive care unit (ICU) of a medium-sized philanthropic general hospital in center-west Minas Gerais.

Methods: Adults and older individuals who underwent real-time polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were evaluated by the nephrology team.

Results: Among the 176 patients, the prevalence of COVID-19 and acute kidney injury (AKI) were 103 (58.5%) and 132 (75%), respectively, and 44 (25%) had chronic kidney disease (CKD) and 16 (15,5%) were positive for SARS-CoV-2. In the Charlson index classification, which estimates the risk of death, a statistically significant difference was identified in the percentages of groups with and without COVID-19 for indices 0, 1, and 2. There was a significant association between kidney disease and ICU mortality (P < 0.05). Patients with CKD had fewer fatal outcomes (13/97, 13.4%) than those with AKI (85/97, 87.6%).

Conclusions: COVID-19 rates remained high long after diagnosis and prevention of SARS-CoV-2 infection. In addition, a higher death rate among patients who developed AKI, whose prevalence was also greater than that in the national literature, regardless of the presence of COVID-19, revealed a worrying scenario and corroborated the need for early and judicious approaches to preserve the lives of patients with AKI admitted to intensive care units.

MeSH terms

  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / mortality
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • COVID-19* / epidemiology
  • COVID-19* / mortality
  • Cross-Sectional Studies
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units* / statistics & numerical data
  • Male
  • Middle Aged
  • Prevalence
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / mortality
  • Risk Factors
  • SARS-CoV-2