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Kidney Week

Abstract: FR-PO1126

Impact of AKI in Critical Patients Hospitalized with COVID-19: A Cohort Study in the Western Amazon

Session Information

  • COVID-19 - II
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Nascimento, Cinthya Oliveira, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Praxedes, Isadora Alves, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Patricio, Emanuelli Maroto, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Barros, Júlia Maia Vilela, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Scharff, Iara Da costa, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Gomes, Natalia Fernandes, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Oliveira, André, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Morello, Débora Gottardo, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Alves Pereira, Lucas Vinicius, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • de Albuquerque, Vitor Pereira, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • De Santana, Flavio Do Amor Divino, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Scharff, Iane Da costa, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • de Paula, Thaís Xavier, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Negri, Isadora Almeida, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Patricio, Poliane Pierra Maroto, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Negri, Isabela De Almeida, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
  • Reis, Vitor H. S., Universidade Federal do Tocantins, Palmas, TO, Brazil
  • Luan, Luan Santos, Centro Universitario Mauricio de Nassau, Cacoal, RO, Brazil
Background

The coronavirus pandemic had a significant impact on areas of the Western Amazon. Intensive care units (COVID ICU) were developed specifically for infected patients in response to this demand. Considering the renal impairment caused by COVID-19, the objective of this study was to analyze the development of acute kidney injury (AKI) and its association with the outcome of critically ill patients.

Methods

A retrospective, multicentric cohort, carried out in two hospitals in a region of the Western Amazon from March 2020 to March 2022. Patients (aged ≥18 years) hospitalized with COVID-19, with a length of stay longer than 48 hours in a COVID ICU, and who did not have previous kidney disease. The exposure was the development of LRA (using the KDIGO classification to define it). The outcome analyzed was in-hospital death.

Results

Of the 385 patients evaluated, 75.1% had previous comorbidities, with a predominance of males (60%), a mean age of 59.3 (18–96) years, and a mean length of stay of 13.5 (2–75) days. Based on the total number of patients in the study, 54.5% of patients developed some degree of AKI (Stage 1: 39.5%, Stage 2: 14.2%, Stage 3: 7.6%, and Stage 3D: 38.7%). Compared with patients who did not have AKI, the number of deaths was higher in patients with AKI (61% vs. 17%; absolute risk difference was 44% [95% CI, 41–46]). The degree of acute kidney injury was directly proportional to the death rate (39.7% AKI 1, 60% AKI 2, 68.7% AKI 3, and 81.4% AKI 3D). Finally, taking those without AKI as the reference group, we observed higher risks of in-hospital death for patients with AKI 1-3D (HR 3.5 [95% CI, 2.6–4.1]).

Conclusion

The occurrence of AKI and the need for renal replacement therapy (AKI 3D) were common in critically ill patients with COVID-19. Advanced stages of AKI are associated with extremely high mortality in these patients. However, it was observed that the development of some degree of kidney injury is already associated with a significant risk of death.