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Title: | Acute kidney injury in critical COVID-19: a multicenter cohort analysis in seven large hospitals in Belgium | Authors: | Schaubroeck, Hannah Vandenberghe, Wim BOER, Willem Boonen , Eva Dewulf , Bram Bourgeois , Camille Dubois, Jasperina Dumoulin, Alexander Fivez, Tom Gunst, Jan Hermans, Greet Lormans, Piet Meersseman, Philippe MESOTTEN, Dieter STESSEL, Bjorn Vanhoof , Marc De Vlieger, Greet Hoste , Eric |
Issue Date: | 2022 | Publisher: | BMC | Source: | CRITICAL CARE, 26 (1) (Art N° 225) | Abstract: | Background Acute kidney injury (AKI) has been reported as a frequent complication of critical COVID-19. We aimed to evaluate the occurrence of AKI and use of kidney replacement therapy (KRT) in critical COVID-19, to assess patient and kidney outcomes and risk factors for AKI and differences in outcome when the diagnosis of AKI is based on urine output (UO) or on serum creatinine (sCr). Methods Multicenter, retrospective cohort analysis of patients with critical COVID-19 in seven large hospitals in Belgium. AKI was defined according to KDIGO within 21 days after ICU admission. Multivariable logistic regression analysis was used to explore the risk factors for developing AKI and to assess the association between AKI and ICU mortality. Results Of 1286 patients, 85.1% had AKI, and KRT was used in 9.8%. Older age, obesity, a higher APACHE II score and use of mechanical ventilation at day 1 of ICU stay were associated with an increased risk for AKI. After multivariable adjustment, all AKI stages were associated with ICU mortality. AKI was based on sCr in 40.1% and UO in 81.5% of patients. All AKI stages based on sCr and AKI stage 3 based on UO were associated with ICU mortality. Persistent AKI was present in 88.6% and acute kidney disease (AKD) in 87.6%. Rapid reversal of AKI yielded a better prognosis compared to persistent AKI and AKD. Kidney recovery was observed in 47.4% of surviving AKI patients. Conclusions Over 80% of critically ill COVID-19 patients had AKI. This was driven by the high occurrence rate of AKI defined by UO criteria. All AKI stages were associated with mortality (NCT04997915). | Notes: | Schaubroeck, H (corresponding author), Univ Ghent, Ghent Univ Hosp, Dept Internal Med & Pediat, Dept Intens Care Med, Corneel Heymanslaan 10, B-9000 Ghent, Belgium. Hannah.Schaubroeck@Ugent.Be |
Keywords: | Acute kidney injury;Kidney replacement therapy;Renal replacement therapy;COVID-19;Intensive care unit;Epidemiology;Mortality;KDIGO;Urine output;Serum creatinine | Document URI: | http://hdl.handle.net/1942/37972 | ISSN: | 1466-609X | e-ISSN: | 1364-8535 | DOI: | 10.1186/s13054-022-04086-x | ISI #: | 000829924800001 | Rights: | The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
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