Acute kidney injury in SARS-CoV2-related pneumonia ICU patients: a retrospective multicenter study

Annals of Intensive Care

Antoine Vieillard-Baron¹  Guillaume Geri¹  Michael Darmon²  Elie Azoulay²  Lara Zafrani³  Muriel Fartoukh⁴  Guillaume Voiriot⁵  Saafa Nemlaghi⁶  Julien Le Marec⁶ 

[1] Medical Intensive Care Unit, Ambroise Paré Hospital, AP-HP, 9 avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France;Paris Saclay University, Gif-sur-Yvette, France;INSERM UMR 1018, CESP, Villejuif, France;FHU SEPSIS, Saclay, France;Medical Intensive Care Unit, Saint Louis Hospital, AP-HP, Paris, France;Paris University, Paris, France;INSERM U1153, Centre of Research in Epidemiology and Statistics, Paris, France;Medical Intensive Care Unit, Saint Louis Hospital, AP-HP, Paris, France;Paris University, Paris, France;INSERM U976, Immunologie Humaine, Pathophysiologie et immunothérapie, Paris, France;Medical Intensive Care Unit, Tenon Hospital, AP-HP, Paris, France;Paris Sorbonne University, Paris, France;Medical Intensive Care Unit, Tenon Hospital, AP-HP, Paris, France;Paris Sorbonne University, Paris, France;INSERM U955 (IMRB), Equipe GEIC2O, 94000, Créteil, France;Paris Sorbonne University, Paris, France;Medical Intensive Care Unit, Pitié-Salpétrière Hospital, AP-HP, Paris, France;INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France;

关键词: Acute kidney injury;    COVID-19;    Renal replacement therapy;   

DOI  :  10.1186/s13613-021-00875-9

来源: Springer

【 摘 要 】

BackgroundWhile acute kidney injury (AKI) is frequent in severe SARS-CoV2-related pneumonia ICU patients, few data are still available about its risk factors.MethodsRetrospective observational study performed in four university affiliated hospitals in Paris. AKI was defined according to the KIDGO guidelines. Factors associated with AKI were picked up using multivariable mixed-effects logistic regression. Independent risk factors of day 28 mortality were assessed using Cox model.Results379 patients (median age 62 [53,69], 77% of male) were included. Half of the patients had AKI (n = 195, 52%) including 58 patients (15%) with AKI stage 1, 44 patients (12%) with AKI stage 2, and 93 patients (25% with AKI stage 3). Chronic kidney disease (OR 7.41; 95% CI 2.98–18.4), need for invasive mechanical ventilation at day 1 (OR 4.83; 95% CI 2.26–10.3), need for vasopressors at day 1 (OR 2.1; 95% CI 1.05–4.21) were associated with increased risk of AKI. Day 28 mortality in the cohort was 26.4% and was higher in patients with AKI (37.4 vs. 14.7%, P < 0.001). Neither AKI (HR 1.35; 95% CI 0.78–2.32) nor AKI stage were associated with mortality (HR [95% CI] for stage 1, 2 and 3 when compared to no AKI of, respectively, 1.02 [0.49–2.10], 1.73 [0.81–3.68] and 1.42 [0.78–2.58]).ConclusionIn this large cohort of SARS-CoV2-related pneumonia patients admitted to the ICU, AKI was frequent, mostly driven by preexisting chronic kidney disease and life sustaining therapies, with unclear adjusted relationship with day 28 outcome.

【 授权许可】

CC BY