Acute kidney injury in SARS-CoV2-related pneumonia ICU
patients: a retrospective multicenter study
by Guillaume Geri, Michael Darmon, Lara Zafrani, Muriel
Fartoukh, Guillaume Voiriot, Julien Le Marec, Saafa Nemlaghi, Antoine
Vieillard-Baron and Elie Azoulay
Annals of Intensive Care volume 11,
Article number: 86 (2021)
Background
While acute kidney injury (AKI) is frequent in severe
SARS-CoV2-related pneumonia ICU patients, few data are still available about
its risk factors.
Methods
Retrospective observational study performed in four
university affiliated hospitals in Paris. AKI was defined according to the
KIDGO guidelines. Factors associated with AKI were picked up using
multivariable mixed-effects logistic regression. Independent risk factors of
day 28 mortality were assessed using Cox model.
Results
379 patients (median age 62 [53,69], 77% of male) were
included. Half of the patients had AKI (n = 195, 52%) including 58 patients
(15%) with AKI stage 1, 44 patients (12%) with AKI stage 2, and 93 patients
(25% with AKI stage 3). Chronic kidney disease (OR 7.41; 95% CI 2.98–18.4),
need for invasive mechanical ventilation at day 1 (OR 4.83; 95% CI 2.26–10.3),
need for vasopressors at day 1 (OR 2.1; 95% CI 1.05–4.21) were associated with increased
risk of AKI. Day 28 mortality in the cohort was 26.4% and was higher in
patients with AKI (37.4 vs. 14.7%, P < 0.001). Neither AKI (HR 1.35;
95% CI 0.78–2.32) nor AKI stage were associated with mortality (HR [95% CI] for
stage 1, 2 and 3 when compared to no AKI of, respectively, 1.02 [0.49–2.10],
1.73 [0.81–3.68] and 1.42 [0.78–2.58]).
Conclusion
In this large cohort of SARS-CoV2-related pneumonia patients
admitted to the ICU, AKI was frequent, mostly driven by preexisting chronic
kidney disease and life sustaining therapies, with unclear adjusted
relationship with day 28 outcome.
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