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Acute Kidney Injury in Critically-Ill COVID-19 Patients.
Arrestier, Romain; Gendreau, Ségolène; Mokrani, David; Bastard, Jean-Philippe; Fellahi, Soraya; Bagate, François; Masi, Paul; d'Humières, Thomas; Razazi, Keyvan; Carteaux, Guillaume; De Prost, Nicolas; Audard, Vincent; Mekontso-Dessap, Armand.
  • Arrestier R; Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Creteil, France.
  • Gendreau S; GRC CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010 Creteil, France.
  • Mokrani D; Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Creteil, France.
  • Bastard JP; GRC CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010 Creteil, France.
  • Fellahi S; Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Creteil, France.
  • Bagate F; Département de Biochimie-Pharmacologie-Biologie Moléculaire-Génétique Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Creteil, France.
  • Masi P; Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est Créteil, 94010 Creteil, France.
  • d'Humières T; Département de Biochimie-Pharmacologie-Biologie Moléculaire-Génétique Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Creteil, France.
  • Razazi K; Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire de Cardio-Métabolisme et Nutrition (ICAN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR S938, Sorbonne Université, 75006 Paris, France.
  • Carteaux G; Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Creteil, France.
  • De Prost N; GRC CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010 Creteil, France.
  • Audard V; Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, 94010 Creteil, France.
  • Mekontso-Dessap A; GRC CARMAS, Faculté de Médecine de Créteil, Université Paris Est Créteil, 94010 Creteil, France.
J Clin Med ; 11(7)2022 Apr 05.
Article in English | MEDLINE | ID: covidwho-1776266
ABSTRACT

PURPOSE:

Acute kidney injury (AKI) is common in patients with COVID-19, however, its mechanism is still controversial, particularly in ICU settings. Urinary proteinuria profile could be a non-invasive tool of interest to scrutinize the pathophysiological process underlying AKI in COVID-19 patients. MATERIAL AND

METHODS:

We conducted a retrospective study between March 2020 and April 2020. All patients with laboratory-confirmed COVID-19 and without end-stage kidney disease requiring renal replacement therapy before ICU admission were included. Our objectives were to assess the incidence and risk factors for AKI and to describe its clinical and biological characteristics, particularly its urinary protein profile.

RESULTS:

Seventy patients were included; 87% needed mechanical ventilation and 61% needed vasopressor during their ICU stay; 64.3% of patients developed AKI and half of them needed dialysis. Total and tubular proteinuria on day 1 were higher in patients with AKI, whereas glomerular proteinuria was similar in both groups. The main risk factor for AKI was shock at admission (OR = 5.47 (1.74-17.2), p < 0.01). Mortality on day 28 was higher in AKI (23/45, 51.1%) than in no-AKI patients (1/25, 4%), p < 0.001. Risk factors for 28-days mortality were AKI with need for renal replacement therapy, non-renal SOFA score and history of congestive heart failure.

CONCLUSIONS:

AKI is common in COVID-19 patients hospitalized in ICU; it seems to be related to tubular lesions rather than glomerular injury and is related to shock at ICU admission.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Randomized controlled trials / Risk factors Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11072029

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Randomized controlled trials / Risk factors Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11072029