Fluid Resuscitation and Progression to Renal Replacement Therapy in Patients With COVID-19.
J Emerg Med
; 62(2): 145-153, 2022 02.
Article
in English
| MEDLINE | ID: covidwho-1487833
ABSTRACT
BACKGROUND:
Coronavirus disease 2019 (COVID-19) is associated with respiratory symptoms and renal effects. Data regarding fluid resuscitation and kidney injury in COVID-19 are lacking, and understanding this relationship is critical.OBJECTIVES:
To determine if there is an association between fluid volume administered in 24 h and development of renal failure in COVID-19 patients.METHODS:
Retrospective chart review; 14 hospitals in Indiana. Included patients were adults admitted between March 11, 2020 and April 13, 2020 with a positive test for severe acute respiratory syndrome coronavirus 2 within 3 days of admission. Patients requiring renal replacement therapy prior to admission were excluded. Volumes and types of resuscitative intravenous fluids in the first 24 h were obtained with demographics, medical history, and other objective data. The primary outcome was initiation of renal replacement therapy. Logistic regression modeling was utilized in creating multivariate models for determining factors associated with the primary outcome.RESULTS:
The fluid volume received in the first 24 h after hospital admission was associated with initiation of renal replacement therapy in two different multivariate logistic regression models. An odds ratio of 1.42 (95% confidence interval 1.01-1.99) was observed when adjusting for age, heart failure, obesity, creatinine, bicarbonate, and total fluid volume. An odds ratio of 1.45 (95% confidence interval 1.02-2.05) was observed when variables significant in univariate analysis were adjusted for.CONCLUSIONS:
Each liter of intravenous fluid administered to patients with COVID-19 in the first 24 h of presentation was independently associated with an increased risk for initiation of renal replacement therapy, supporting judicious fluid administration in patients with this disease.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Acute Kidney Injury
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Limits:
Adult
/
Humans
Language:
English
Journal:
J Emerg Med
Journal subject:
Emergency Medicine
Year:
2022
Document Type:
Article
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