COVID-19-associated acute kidney injury patients treated with renal replacement therapy in the intensive care unit: A multicenter study in São Paulo, Brazil.
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Samaan Farid, Carneiro de Paula Elisa, de Lima Souza Fabrizzio Batista Guimarães, Mendes Luiz Fernando Cardoso, Rossi Paula Regina Gan, Freitas Rafaela Andrade Penalva, Nakagawa Fernando Takahashi, Maciel Alexandre Toledo, Aranha Sylvia, Osawa Eduardo, Konigsfeld Henrique Pinheiro, da Silva Riberto Garcia, de Souza Ricardo Barbosa Cintra, Coutinho Saurus Mayer, Vieira Tales Dantas, Thomaz Karina De Bonis, Flato Elias Marcos Silva, da Silva Renata Cristina, Andrade Lucas Vicente, Badaoui Muna, Badaoui Eduardo Pogetti, Goes Miguel Ângelo, do Amaral Sergio Henrique, Cunha Karlla, Muniz Inês Marin, Sampaio Jacqueline Siqueira, Durão Junior Marcelino de Souza, Zanetta Dirce M Trevisan, Burdmann Emmanuel A
Аннотация
METHODS: This multicenter, retrospective, observational study was conducted in the intensive care units of 13 public and private hospitals in the metropolitan region of the municipality of São Paulo. Patients hospitalized in an intensive care unit, aged ≥ 18 years, and treated with RRT due to COVID-19-associated AKI were included.
RESULTS: The study group consisted of 375 patients (age 64.1 years, 68.8% male). Most (62.1%) had two or more comorbidities: 68.8%, arterial hypertension; 45.3%, diabetes; 36.3%, anemia; 30.9%, obesity; 18.7%, chronic kidney disease; 15.7%, coronary artery disease; 10.4%, heart failure; and 8.5%, chronic obstructive pulmonary disease. Death occurred in 72.5% of the study population (272 patients). Among the 103 survivors, 22.3% (23 patients) were discharged on RRT. In a multiple regression analysis, the independent factors associated with death were the number of organ dysfunctions at admission and RRT efficiency.
CONCLUSION: AKI-RRT associated with COVID-19 occurred in patients with an elevated burden of comorbidities and was associated with high mortality (72.5%). The number of organ dysfunctions during hospitalization and RRT efficiency were independent factors associated with mortality. A meaningful portion of survivors was discharged while dependent on RRT (22.3%).