COVID-19-associated acute kidney injury patients treated with renal replacement therapy in the intensive care unit: A multicenter study in São Paulo, Brazil
PLos ONE
; 17(1): 0261958, Jan. 2022. graf, tab
Article
in English
| CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1353157
Responsible library:
BR79.1
ABSTRACT
INTRODUCTION:
Multicenter studies involving patients with acute kidney injury (AKI) associated with the disease caused by the new coronavirus (COVID-19) and treated with renal replacement therapy (RRT) in developing countries are scarce. The objectives of this study were to evaluate the demographic profile, clinical picture, risk factors for mortality, and outcomes of critically ill patients with AKI requiring dialysis (AKI-RRT) and with COVID-19 in the megalopolis of São Paulo, Brazil.METHODS:
This multicenter, retrospective, observational study was conducted in the intensive care units of 13 public and private hospitals in the metropolitan region of the municipality of São Paulo. Patients hospitalized in an intensive care unit, aged ≥ 18 years, and treated with RRT due to COVID-19-associated AKI were included.RESULTS:
The study group consisted of 375 patients (age 64.1 years, 68.8% male). Most (62.1%) had two or more comorbidities 68.8%, arterial hypertension; 45.3%, diabetes; 36.3%, anemia; 30.9%, obesity; 18.7%, chronic kidney disease; 15.7%, coronary artery disease; 10.4%, heart failure; and 8.5%, chronic obstructive pulmonary disease. Death occurred in 72.5% of the study population (272 patients). Among the 103 survivors, 22.3% (23 patients) were discharged on RRT. In a multiple regression analysis, the independent factors associated with death were the number of organ dysfunctions at admission and RRT efficiency.CONCLUSION:
AKI-RRT associated with COVID-19 occurred in patients with an elevated burden of comorbidities and was associated with high mortality (72.5%). The number of organ dysfunctions during hospitalization and RRT efficiency were independent factors associated with mortality. A meaningful portion of survivors was discharged while dependent on RRT (22.3%).
Full text:
Available
Collection:
National databases
/
Brazil
Database:
CONASS
/
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Coronavirus
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Renal Insufficiency, Chronic
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Intensive Care Units
Type of study:
Controlled clinical trial
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Etiology study
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Observational study
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Risk factors
Country/Region as subject:
South America
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Brazil
Language:
English
Journal:
PLos ONE
Year:
2022
Document type:
Article
Institution/Affiliation country:
Department of General Surgery, Ipiranga Hospital Care Management Unit/BR
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Department of High Complexity Patients, Grupo NotreDame Intermédica/BR
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Imed Research Group, São Camilo Pompeia Hospital/BR
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Internal medicine, Dante Pazzanese Institute of Cardiology/BR
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Medical Board, Municipal Hospital Vereador José Storopolli/BR
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Nephrology Division, Federal University of São Paulo/BR
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Nephrology Division, Leforte Liberdade Hospital/BR
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Nephrology Division, Santa Cruz Hospital/BR
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Nephrology Division, São Francisco Hospital/BR
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Nephrology Division, University of São Paulo Medical School/BR