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Abstract: PO0025

Critically Ill Patients with COVID-19 and AKI: Clinical Characteristics and Outcomes

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • El Mouhayyar, Christopher E., Saint Elizabeth's Medical Center, Brighton, Massachusetts, United States
  • Dewald, Jonathan, Saint Elizabeth's Medical Center, Brighton, Massachusetts, United States
  • Cabrales, Jose, Saint Elizabeth's Medical Center, Brighton, Massachusetts, United States
  • Tighiouart, Hocine, Tufts Medical Center, Boston, Massachusetts, United States
  • Moraco, Andrew H., Saint Elizabeth's Medical Center, Brighton, Massachusetts, United States
  • Jaber, Bertrand L., Saint Elizabeth's Medical Center, Brighton, Massachusetts, United States
  • Balakrishnan, Vaidyanathapuram, Saint Elizabeth's Medical Center, Brighton, Massachusetts, United States
Background

Acute kidney injury (AKI) is a well-recognized complication of COVID-19. In this retrospective cohort study, we describe the clinical characteristics and outcomes of patients with severe COVID-19 in 8 intensive care units (ICUs) during the first wave of the pandemic.

Methods

Demographic, clinical, laboratory characteristics, and outcome data, including need for renal replacement therapy (RRT), mechanical ventilation, mortality, and RRT dependence at discharge and at 3 and 6 months, were extracted from the electronic medical record (EMR) between March and July 2020. Using nadir-to-peak serum creatinine, AKI and its stages were defined by the KDIGO consensus. Group comparisons were performed using ANOVA and chi square tests.

Results

After excluding 20 patients with end-stage kidney failure, 479 patients with severe COVID-19 were included. Table 1 displays the characteristics and outcomes of the cohort stratified by AKI. 409 (89.2%) patients developed AKI, with 194 (42.3%) developing stage-3 AKI. Male gender, white race, obesity, and COPD were associated with higher stages of AKI severity. 83 patients (18.1%) required RRT of which 27 (32.5%) survived, and 12 (44.4%) remained dialysis-dependent at hospital discharge. Follow up at 3-months and 6-months indicated dialysis dependence in 5 (45.5%) and 4 (36.4%) of 11 patients (1 died), respectively.

Conclusion

AKI is highly prevalent in our cohort and peak serum creatinine occurs within 3 days of intubation. Long-term dialysis dependence is of concern and merits further study. Multivariable analyses are under way to identify factors that are associated with severe AKI, need for RRT and in-hospital death.