ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO078

A Retrospective Analysis of Fluid Balance in Patients With AKI and Respiratory Failure due to COVID-19

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Sharma, Pranav, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
  • Bhagat, Amar Mahesh, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
  • Madu, Chioma, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
  • Lebowitz, Jonathan, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
  • Saro-Nunez, Lilian, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
  • Khalil, Steve I., Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
Background

The optimal amount of hydration for patients with severe COVID-19 infection and AKI is unknown. This study aims to investigate the impact of fluid management strategy and outcomes in patients with AKI and respiratory failure due to COVID-19.

Methods

Data was gathered from a retrospective chart review of patients with hypoxia due to COVID-19 infection and stage 2 or greater AKI. Primary outcome was the difference in net fluid balance between patients who were successfully weaned to lower levels of oxygen support and discharged compared to those who died or remained ventilator dependent.

Results

Of 58 cases, 41 died, 3 remained ventilator-dependent, and 14 were discharged without supplemental oxygen. The groups differed in net fluid balance (-10,065 cc vs +7,980 cc, p <0.001) and daily fluid balance (-367 vs. 515 cc/day, p <0.001) with a substantially lower mean fluid balance in patients who survived with minimal requirement for supplemental oxygen. Patients who maintained a positive fluid balance were significantly more likely to become ventilator dependent or die (OR: 40.7, 95% CI: 5.3 - 312.9). A fluid restrictive strategy did not reduce the likelihood of recovery from AKI or increase the need for renal replacement therapy.

Conclusion

In our cohort, patients with COVID-19 and AKI who survived with minimal or no oxygen requirements tended to have negative fluid balance in contrast to those who died or remained ventilator-dependent. A fluid restrictive strategy with judicious volume removal using diuretics or dialysis may lead to improved outcomes in COVID-19 patients with AKI.