Costa RLD, Sória TC, Salles EF, Gerecht AV, Corvisier MF, Menezes MADM, Ávila CDS, Silva ECDF, Pereira SRN, Simvoulidis LFN. Acute kidney injury in patients with Covid-19 in a Brazilian ICU: incidence, predictors and in-hospital mortality.
ACTA ACUST UNITED AC 2021;
43:349-358. [PMID:
33570081 PMCID:
PMC8428632 DOI:
10.1590/2175-8239-jbn-2020-0144]
[Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 10/12/2020] [Indexed: 02/27/2023]
Abstract
Introduction:
There is little data in the literature on acute kidney injury (AKI) in
Covid-19 cases, although relevant in clinical practice in the ICU,
especially in Brazil. Our goal was to identify the incidence of AKI,
predictive factors and impact on hospital mortality.
Method:
Retrospective cohort of patients with Covid-19 admitted to the ICU. AKI was
defined according to KDIGO criteria. Data was collected from electronic
medical records between March 17 and April 26.
Results:
Of the 102 patients, 55.9% progressed with AKI, and the majority (66.7%) was
classified as stage 3. Multivariate logistic regression showed age (RC
1.101; 95% CI 1.026 - 1.181; p = 0.0070), estimated
glomerular filtration rate - eGFR (RC 1.127; 95% CI 1.022 - 1.243;
p = 0.0170) and hypertension (RC 3.212; 95% CI 1.065 -
9.690; p = 0.0380) as independent predictors of AKI.
Twenty-three patients died. In the group without kidney injury, there were
8.9% deaths, while in the group with AKI, 33.3% of patients died (RR 5.125;
95% CI 1.598 - 16.431; p = 0.0060). The average survival,
in days, was higher in the group without AKI. Cox multivariate analysis
showed age (RR 1.054; 95% CI 1.014 - 1.095; p = 0.0080) and
severe acute respiratory distress syndrome (RR 8.953; 95% CI 1.128 - 71.048;
p = 0.0380) as predictors of hospital mortality.
Conclusion:
We found a high incidence of AKI; and as predictive factors for its
occurrence: age, eGFR and hypertension. AKI was associated with higher
hospital mortality.
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