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Timing of Renal Replacement Therapy in AKI Patients: standardize or personalize?
Blood Purification ; 51(Supplement 2):44, 2022.
Article in English | EMBASE | ID: covidwho-2214193
ABSTRACT

Background:

Acute kidney injury (AKI) occurs in about 10-15 % of hospitalized patients and represents a significant cause of death. This percentage, during the Covid-19 pandemic, seems to have increased. A meta-analysis reports an overall incidence of AKI, in patients with SARS-CoV2 infection, of 20.4%. The determining cause is not yet clear direct and indirect damage (from cytokines cascade, iatrogenic damage, organ cross-talk, sepsis, mechanical ventilation, endothelial dysfunction and hypercoagulation) participate in the determination of the loss of renal function. Material(s) and Method(s) We have selected all patients, including SARS-CoV2 infection, admitted to the AOU Polyclinic 'G.Martino' from February 2022 to April 2022, who needed renal replacement therapy (RRT). Result(s) Twelve patients (50%) had SARS-CoV2 infection. Table 1 reports the characteristics of the patients divided according to SARS-CoV2 infection at admission;no significant difference is present. In accordance to the know negative prognostic value of AKI stage 3, 18 patients (75%) died during hospitalization. We then divided the patients into two groups according to death (tab.2). In death patients median creatinine was higher than in survival patients, but, on the other hand, in death patients hemodialytic therapy was done later. Conclusion(s) Our data show the importance of timing in the start of renal replacement therapy and the impossibility of reducing the choice to laboratory indications. Patients with increased renal impairment may be clinically more stable so starting dialysis treatment may not be an emergency. Conversely, patients who do not have a major alteration of the laboratory parameters, but with a more complex clinical picture, may have a better prognosis if, after an overall evaluation, the renal replacement treatment is started early. Moreover, our data show that blood chemical analysis data at admission in Covid-19 patients are not different from patients without Covid-19. Additionally, patients with SARS-CoV2 infection, may have clinical features (related for example to organ cross-talk or the need for mechanical ventilation) that could benefit from an early start of hemodialytic treatment with better outcomes.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Blood Purification Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Blood Purification Year: 2022 Document Type: Article