Spectrum and Outcomes of Acute Kidney Injury in a Non-Covid Intensive Care Unit during Covid Pandemic: Single Centre Study from North India

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a major risk factor for mortality in ICU patients. The aim of this study was to evaluate the spectrum and outcomes of non-COVID related AKI admitted to non-COVID intensive care units of a tertiary care hospital during COVID pandemic. AIM OF THE STUDY To study the Spectrum and Outcomes of Acute Kidney Injury in a Non-COVID Intensive Care Unit during COVID Pandemic METHODS: Patients were prospectively enrolled from February 2020 to June 2021 using a predesigned standardized pro forma as per the inclusion and exclusion criteria. Demographic details, comorbid conditions, biochemical parameters, urine output system affection, renal replacement therapy (RRT) details, and fluid replacement were recorded. Outcome measures assessed were serum creatinine at transfer-out from ICU serum creatinine at discharge days of ICU stay and days of hospital stay death/ discharge and requirement of RRT after discharge. RESULT(S) 200 patients of AKI getting admitted to ICU were included in this study. Diabetes mellitus (19.5%) was the most common comorbidity. AKI was most seen in the post-surgery setting (33%), and severe non-surgical sepsis (37%). The most important risk factors predicting in-hospital mortality in AKI patients were hepatic dysfunction (HR-3.471, p = 0.001), septicemia (HR-3.342, p = 0.0001), age >60 years (HR-4.000, p = 0.026), higher baseline SOFA score (HR-1.107, p = 0.001), anemia (HR-0.879, p = 0.003), and reduced serum iron levels (HR- 0.982, p = 0.001). CONCLUSION(S) Presence of age >60 years, hepatic dysfunction, septicemia, higher baseline SOFA score, anemia, and reduced serum iron emerged to be the most important predictors of mortality among intensive care requiring AKI patients. The surgical AKI incidence was less due to lesser number of elective surgeries during the COVID pandemic.