Acute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes
Abstract Introduction: Acute kidney injury (AKI) in the setting of COVID-19 is associated with worse clinical and renal outcomes, with limited long-term data. Aim: To evaluate critically ill COVID-19 patients with AKI that required nephrologist consultation (NC-AKI) in a tertiary hospital. Method...
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| Format: | Article |
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Sociedade Brasileira de Nefrologia
2025-01-01
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| Series: | Brazilian Journal of Nephrology |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002025000100306&lng=en&tlng=en |
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| author | Juliana Alves Manhães de Andrade Gisele Meinerz Raphael Palma Eduardo Rech Marco Antônio Vinciprova Dall’Agnese Cristiane Bundchen Fernanda Bordignon Nunes Gisele Branchini Elizete Keitel |
| author_facet | Juliana Alves Manhães de Andrade Gisele Meinerz Raphael Palma Eduardo Rech Marco Antônio Vinciprova Dall’Agnese Cristiane Bundchen Fernanda Bordignon Nunes Gisele Branchini Elizete Keitel |
| author_sort | Juliana Alves Manhães de Andrade |
| collection | DOAJ |
| description | Abstract Introduction: Acute kidney injury (AKI) in the setting of COVID-19 is associated with worse clinical and renal outcomes, with limited long-term data. Aim: To evaluate critically ill COVID-19 patients with AKI that required nephrologist consultation (NC-AKI) in a tertiary hospital. Methods: Prospective single-center cohort of critically ill COVID-19 adult patients with NC-AKI from May 1st, 2020, to April 30th, 2021. Kidney replacement therapy (KRT), recovery of kidney function, and death at 90-day and 1-year follow-up were evaluated. Results: 360 patients were included, 60.6% were male, median age was 66.0 (57.0–72.0) years, 38.1% had diabetes, and 68.6% had hypertension. AKI stages 1, 2, and 3 were detected in 3.6%, 5.6%, and 90.8% of patients, respectively. KRT was indicated in 90% of patients. At the 90-day follow-up, 88.1% of patients died and 10.0% had recovered kidney function. Female gender (p = 0.047), older age (p = 0.047), AKI stage 3 (p = 0.005), requirement of KRT (p < 0.0001), mechanical ventilation (p < 0.0001), and superimposed bacterial infection (p < 0.0001) were significantly associated death within 90 days. At 1 year, mortality was 89.3%. Amongst surviving patients, 72% recovered kidney function, although with significantly lower eGFR compared to baseline (85.5 ± 23.6 vs. 65.9 ± 24.8 mL/min, p = 0.003). Conclusion: Critically ill COVID-19 patients with NC-AKI presented a high frequency of AKI stage 3 and KRT requirement, with a high 90-day mortality. Surviving patients had high rates of recovery of kidney function, with a lower eGFR at one-year follow-up compared to baseline. |
| format | Article |
| id | doaj-art-06f1b8b9dbfd4eefba39c4069e8fbbe1 |
| institution | Kabale University |
| issn | 2175-8239 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Sociedade Brasileira de Nefrologia |
| record_format | Article |
| series | Brazilian Journal of Nephrology |
| spelling | doaj-art-06f1b8b9dbfd4eefba39c4069e8fbbe12025-01-21T07:36:51ZengSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology2175-82392025-01-0147110.1590/2175-8239-jbn-2024-0107enAcute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomesJuliana Alves Manhães de Andradehttps://orcid.org/0009-0008-3519-1560Gisele Meinerzhttps://orcid.org/0000-0002-6784-0894Raphael Palmahttps://orcid.org/0000-0003-2446-3168Eduardo Rechhttps://orcid.org/0009-0009-7209-410XMarco Antônio Vinciprova Dall’Agnesehttps://orcid.org/0000-0001-5829-5954Cristiane Bundchenhttps://orcid.org/0000-0003-1132-605XFernanda Bordignon Nuneshttps://orcid.org/0000-0003-1028-7490Gisele Branchinihttps://orcid.org/0000-0003-2524-8603Elizete Keitelhttps://orcid.org/0000-0002-5519-8224Abstract Introduction: Acute kidney injury (AKI) in the setting of COVID-19 is associated with worse clinical and renal outcomes, with limited long-term data. Aim: To evaluate critically ill COVID-19 patients with AKI that required nephrologist consultation (NC-AKI) in a tertiary hospital. Methods: Prospective single-center cohort of critically ill COVID-19 adult patients with NC-AKI from May 1st, 2020, to April 30th, 2021. Kidney replacement therapy (KRT), recovery of kidney function, and death at 90-day and 1-year follow-up were evaluated. Results: 360 patients were included, 60.6% were male, median age was 66.0 (57.0–72.0) years, 38.1% had diabetes, and 68.6% had hypertension. AKI stages 1, 2, and 3 were detected in 3.6%, 5.6%, and 90.8% of patients, respectively. KRT was indicated in 90% of patients. At the 90-day follow-up, 88.1% of patients died and 10.0% had recovered kidney function. Female gender (p = 0.047), older age (p = 0.047), AKI stage 3 (p = 0.005), requirement of KRT (p < 0.0001), mechanical ventilation (p < 0.0001), and superimposed bacterial infection (p < 0.0001) were significantly associated death within 90 days. At 1 year, mortality was 89.3%. Amongst surviving patients, 72% recovered kidney function, although with significantly lower eGFR compared to baseline (85.5 ± 23.6 vs. 65.9 ± 24.8 mL/min, p = 0.003). Conclusion: Critically ill COVID-19 patients with NC-AKI presented a high frequency of AKI stage 3 and KRT requirement, with a high 90-day mortality. Surviving patients had high rates of recovery of kidney function, with a lower eGFR at one-year follow-up compared to baseline.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002025000100306&lng=en&tlng=enCOVID-19Acute Kidney InjuryMortality |
| spellingShingle | Juliana Alves Manhães de Andrade Gisele Meinerz Raphael Palma Eduardo Rech Marco Antônio Vinciprova Dall’Agnese Cristiane Bundchen Fernanda Bordignon Nunes Gisele Branchini Elizete Keitel Acute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes Brazilian Journal of Nephrology COVID-19 Acute Kidney Injury Mortality |
| title | Acute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes |
| title_full | Acute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes |
| title_fullStr | Acute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes |
| title_full_unstemmed | Acute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes |
| title_short | Acute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes |
| title_sort | acute kidney injury in critically ill covid 19 patients in a tertiary hospital short and long term kidney and patient outcomes |
| topic | COVID-19 Acute Kidney Injury Mortality |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002025000100306&lng=en&tlng=en |
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