Abstract: FR-PO031
Kidney Outcomes in Critically Ill Patients With and Without COVID-19
Session Information
- COVID-19: AKI Outcomes, Biomarkers, Treatments, Case Reports
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Tian, Frances, University of Washington, Seattle, Washington, United States
- Zelnick, Leila R., University of Washington, Seattle, Washington, United States
- Wurfel, Mark M., University of Washington, Seattle, Washington, United States
- Bhatraju, Pavan K., University of Washington, Seattle, Washington, United States
- Kestenbaum, Bryan R., University of Washington, Seattle, Washington, United States
Background
Case series have described high rates of AKI in critically ill persons with covid-19. However, no study has directly compared kidney outcomes in similarly ill persons with and without covid-19 that are contemporaneously enrolled.
Methods
We assessed 346 participants from a study of covid-19 in critical illness enrolled from University of Washington from April 2020 to May 2021. Patients in the ICU were recruited if symptoms of lower respiratory tract infection prompted covid testing. 2/3 of the cohort were covid positive; the remaining 1/3 had another cause of respiratory illness and served as controls. We defined major adverse kidney events (MAKE) as doubling of serum creatinine, dialysis, or death during hospitalization. Among 186 patients with available urine samples, we also assessed kidney injury molecule-1 (KIM-1), epidermal growth factor (EGF), and Cr . We used inverse probability of treatment weighting with propensity scores to increase similarity between the comparison groups.
Results
Mean age was 55 years; 64% were male, and mean admission serum Cr was 1.3 ± 1.0 mg/dL. Baseline characteristics, including APACHE III and SOFA scores, were similar between groups after propensity weighting. Among Covid-19 patients the incidence of MAKE was 45% and in non-covid-19 patients was 26%. Covid-19 positivity was associated with a 55% greater incidence of MAKE and each component of MAKE was numerically higher in the covid-19 positive group (figure). The covid positive group had lower urine EGF levels (indexed to urine Cr) over time. Urine KIM-1 levels were similar.
Conclusion
The incidences of clinical kidney outcomes are numerically higher in critically ill patients with covid-19 compared with similarly ill control patients without covid-19. Urinary concentrations of EGF are lower in covid positive patients.