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Acute Kidney Injury and COVID-19: A Picture from an Intensive Care Unit.
Alessandri, Francesco; Pistolesi, Valentina; Manganelli, Chiara; Ruberto, Franco; Ceccarelli, Giancarlo; Morabito, Santo; Pugliese, Francesco.
  • Alessandri F; Department of General and Specialist Surgery "Paride Stefanini", "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy, francesco.alessandri@uniroma1.it.
  • Pistolesi V; Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
  • Manganelli C; Department of General and Specialist Surgery "Paride Stefanini", "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
  • Ruberto F; Department of General and Specialist Surgery "Paride Stefanini", "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
  • Ceccarelli G; Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
  • Morabito S; Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
  • Pugliese F; Department of General and Specialist Surgery "Paride Stefanini", "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
Blood Purif ; 50(6): 767-771, 2021.
Article in English | MEDLINE | ID: covidwho-1013077
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Kidney Failur PROCESS_OF C0030705
Subject
Kidney Failur
Predicate
PROCESS_OF
Object
C0030705
3. Continuous Renal Replacement Therapy AFFECTS Oliguria
Subject
Continuous Renal Replacement Therapy
Predicate
AFFECTS
Object
Oliguria
4. Continuous Renal Replacement Therapy TREATS Patients
Subject
Continuous Renal Replacement Therapy
Predicate
TREATS
Object
Patients
5. Kidney LOCATION_OF Complication
Subject
Kidney
Predicate
LOCATION_OF
Object
Complication
6. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
7. Kidney Failure, Acute PROCESS_OF Patients
Subject
Kidney Failure, Acute
Predicate
PROCESS_OF
Object
Patients
8. Continuous Renal Replacement Therapy AFFECTS Oliguria
Subject
Continuous Renal Replacement Therapy
Predicate
AFFECTS
Object
Oliguria
9. Continuous Renal Replacement Therapy TREATS Patients
Subject
Continuous Renal Replacement Therapy
Predicate
TREATS
Object
Patients
10. Kidney LOCATION_OF Complication
Subject
Kidney
Predicate
LOCATION_OF
Object
Complication
ABSTRACT

INTRODUCTION:

Acute kidney injury (AKI) is a frequent complication in coronavirus disease 2019 (COVID-19) patients admitted to intensive care unit (ICU) for severe respiratory failure. The aim is to evaluate the rate of AKI, defined according to Kidney Disease Improving Global Outcome guidelines, in a series of critical COVID-19 patients admitted to the ICU of a single tertiary teaching hospital.

METHODS:

From April to May 2020, all consecutive critically ill COVID-19 patients admitted to the ICU who did not meet exclusion criteria (length of ICU stay <48 h, ESRD requiring dialysis, and patients still hospitalized in ICU at the time of data analysis) were enrolled in this study. Patients were stratified according to the highest AKI stage attained during ICU stay.

RESULTS:

Sixty-one patients were included in the analysis. AKI was observed in 35/61 patients (57.4%) 25/35 episodes (71.4%) were observed within the first 7 days. AKI was classified as follows 17.1% stage 1, 25.7% stage 2, and 57.2% stage 3. Fourteen out of 20 stage-3 patients required continuous renal replacement therapy (CRRT), mostly related to persistent oliguria. The overall ICU mortality was 68.9%, and it was higher in patients developing AKI if compared to no-AKI patients (p = 0.006). Renal function recovery of any grade was observed in 14 out of 35 AKI patients (40%). Among patients undergoing CRRT, 13 patients were still dialysis dependent at the time of death.

CONCLUSION:

In critical COVID-19 patients, ICU mortality is particularly high, especially in patients developing AKI. An accurate monitoring of renal function in early phases of respiratory failure should be ensured in order to timely apply any strategy aimed at limiting renal complications during ICU stay.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Clinical Practice Guide Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Blood Purif Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Clinical Practice Guide Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Blood Purif Year: 2021 Document Type: Article