Kidney Week

Abstract: PO0049

Risk Factors for RRT and Mortality in Patients with COVID-19-Related AKI in São Paulo, Brazil

Session Information

• COVID-19: Epidemiology, Outcomes, Complications, and Risk Factors
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Almeida, Carlos Augusto Pereira de, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Carlos Augusto Pereira de Almeida, MD

• Arantes de Oliveira, Marcia Fernanda, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Marcia Fernanda Arantes de Oliveira,

• Sandoval Cabrera, Carla Paulina, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Carla Paulina Sandoval Cabrera,

• Teixeira, Alexandre Macedo, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Alexandre Macedo Teixeira,

• Espinosa Armijos, Jorge Leonardo, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Jorge Leonardo Espinosa Armijos,

• Valle, Eduardo de Oliveira, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Eduardo de Oliveira Valle,

• Reichert, Bernardo V., University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Bernardo V. Reichert,

• Sales, Gabriel Teixeira Montezuma, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Gabriel Teixeira Montezuma Sales,

• Smolentzov, Igor, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Igor Smolentzov,

• Strufaldi, Fernando Louzada, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Fernando Louzada Strufaldi,

• Lins, Paulo Ricardo Gessolo, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Paulo Ricardo Gessolo Lins,

• Rodrigues, Camila Eleuterio, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Camila Eleuterio Rodrigues,

• Seabra, Victor F., University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Victor F. Seabra,

• Andrade, Lucia, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil

Lucia Andrade,

Background

In COVID-19, as in SARS, the degree of kidney injury can have major implications for the clinical outcomes. Early reports indicate that, among patients with COVID-19, AKI is common and is associated with worse outcomes. However, COVID-19-related AKI among ICU patients in Brazil has not been well described.

Methods

This was a retrospective observational study of the electronic health records of patients with COVID-19-related AKI admitted to the Hospital das Clínicas in the city of São Paulo, Brazil, between March and August of 2020. We applied only KDIGO criteria 2 and 3. We used logistic regression to analyze risk factors for the composite outcome of mortality or RRT.

Results

Among the 694 patients with COVID-19-related AKI, the mean age was 63 years and mortality was 66.4%; 41% needed vasoactive drugs, 66% needed mechanical ventilation, and 72% needed dialysis. Univariate analysis showed the following risk factors for mortality and RRT at admission: male sex; diabetes; CKD; vasoactive drug use; mechanical ventilation; acidemia; elevated lactate, magnesium, potassium, creatinine, C-reactive protein, creatine phosphokinase, total bilirrubin; proteinuria; hematuria; and increased fractional excretion of potassium (n=98) and sodium (n=110). The factors that remained significant in the multivariate analysis were male sex, vasoactive drug use, serum magnesium >2.5 mg/dL and oliguria (24-h urine output <500 mL).

Conclusion

In ICU patients with COVID-19-related AKI, in Brazil and elsewhere, in-hospital mortality is high. The exact mechanism by which hypermagnesemia increases mortality in such patients merits further study. Supported by FAPESP.

Risk factors for mortality or RRT in patients with COVID-19-related AKI in Brazil

Funding

• Government Support – Non-U.S.