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Acute kidney injury in critical COVID-19: a multicenter cohort analysis in seven large hospitals in Belgium.
Schaubroeck, Hannah; Vandenberghe, Wim; Boer, Willem; Boonen, Eva; Dewulf, Bram; Bourgeois, Camille; Dubois, Jasperina; Dumoulin, Alexander; Fivez, Tom; Gunst, Jan; Hermans, Greet; Lormans, Piet; Meersseman, Philippe; Mesotten, Dieter; Stessel, Björn; Vanhoof, Marc; De Vlieger, Greet; Hoste, Eric.
  • Schaubroeck H; Department of Intensive Care Medicine, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium. Hannah.Schaubroeck@Ugent.Be.
  • Vandenberghe W; Department of Intensive Care Medicine, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
  • Boer W; Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, Ziekenhuis Oost Limburg ZOL, Genk, Belgium.
  • Boonen E; Department of Intensive Care Medicine, AZ Turnhout, Turnhout, Belgium.
  • Dewulf B; Department of Anaesthesiology and Critical Care Medicine, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.
  • Bourgeois C; Department of Anaesthesiology and Critical Care Medicine, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.
  • Dubois J; Department of Intensive Care Medicine and Anaesthesiology, Jessa Hospital, Hasselt, Belgium.
  • Dumoulin A; Department of Intensive Care Medicine, AZ Delta, Roeselare, Belgium.
  • Fivez T; Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, Ziekenhuis Oost Limburg ZOL, Genk, Belgium.
  • Gunst J; Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium.
  • Hermans G; Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
  • Lormans P; Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
  • Meersseman P; Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
  • Mesotten D; Department of Intensive Care Medicine, AZ Delta, Roeselare, Belgium.
  • Stessel B; Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
  • Vanhoof M; Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, Ziekenhuis Oost Limburg ZOL, Genk, Belgium.
  • De Vlieger G; Faculty of Medicine and Life Sciences, UHasselt, LCRC, Diepenbeek, Belgium.
  • Hoste E; Department of Intensive Care Medicine and Anaesthesiology, Jessa Hospital, Hasselt, Belgium.
Crit Care ; 26(1): 225, 2022 07 25.
Article in English | MEDLINE | ID: covidwho-1962881
ABSTRACT

BACKGROUND:

Acute kidney injury (AKI) has been reported as a frequent complication of critical COVID-19. We aimed to evaluate the occurrence of AKI and use of kidney replacement therapy (KRT) in critical COVID-19, to assess patient and kidney outcomes and risk factors for AKI and differences in outcome when the diagnosis of AKI is based on urine output (UO) or on serum creatinine (sCr).

METHODS:

Multicenter, retrospective cohort analysis of patients with critical COVID-19 in seven large hospitals in Belgium. AKI was defined according to KDIGO within 21 days after ICU admission. Multivariable logistic regression analysis was used to explore the risk factors for developing AKI and to assess the association between AKI and ICU mortality.

RESULTS:

Of 1286 patients, 85.1% had AKI, and KRT was used in 9.8%. Older age, obesity, a higher APACHE II score and use of mechanical ventilation at day 1 of ICU stay were associated with an increased risk for AKI. After multivariable adjustment, all AKI stages were associated with ICU mortality. AKI was based on sCr in 40.1% and UO in 81.5% of patients. All AKI stages based on sCr and AKI stage 3 based on UO were associated with ICU mortality. Persistent AKI was present in 88.6% and acute kidney disease (AKD) in 87.6%. Rapid reversal of AKI yielded a better prognosis compared to persistent AKI and AKD. Kidney recovery was observed in 47.4% of surviving AKI patients.

CONCLUSIONS:

Over 80% of critically ill COVID-19 patients had AKI. This was driven by the high occurrence rate of AKI defined by UO criteria. All AKI stages were associated with mortality (NCT04997915).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: Crit Care Year: 2022 Document Type: Article Affiliation country: S13054-022-04086-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: Crit Care Year: 2022 Document Type: Article Affiliation country: S13054-022-04086-x