Abstract: FR-PO1134
Patient Outcomes in De Novo Kidney Replacement Therapy Requiring AKI Following COVID-19 Infection
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
- Chaudhary, Sanjay, Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
- Ghimire, Manoj, Mayo Clinic Florida, Jacksonville, Florida, United States
- Mundhra, Gunjan, Mayo Clinic Florida, Jacksonville, Florida, United States
- Guru, Pramod K., Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
- Hickson, LaTonya J., Mayo Clinic Florida, Jacksonville, Florida, United States
- Kashani, Kianoush, Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
Background
Among patients infected with COVID-19, AKI affects >20% of hospitalized patients and >50% of patients admitted to the ICU. While kidney function recovery in COVID-19 patients at discharge and for a short duration of follow up after discharge has been studied, little is known about longer-term outcomes and kidney function recovery in patients who go on to require dialysis during the acute hospitalization for COVID. The aim of the study was to look at the factors associated with dialysis requiring AKI, the impact on survival, the factors associated with continued need for dialysis in patients who start KRT during hospitalization for COVID-19 pneumonia and rate of kidney function recovery following the initiation of KRT.
Methods
A retrospective observational cohort study was conducted at the Mayo Clinic Hospital system in the United States. The study included hospitalized patients aged 18 years or older who were admitted between January 1, 2020, and December 31, 2022, and had a diagnosis of both SARS-CoV-2 infection and new onset Acute Kidney Injury (AKI) requiring Kidney Replacement Therapy (KRT).
The primary outcome was mortality and the secondary outcomes included incidence of the composite outcome of death, requirement for KRT and kidney function decline of >25% from baseline at 60 days and 365 days (MAKE60 and MAKE365).
Results
A total of 145 patients required Kidney Replacement Therapy (KRT). Among them, 64 patients (44.1%) survived to discharge and 21 patients (14.5%) remained dependent on dialysis at discharge. At 60 days, major adverse kidney event (MAKE60) was 17.2%. Among the patients discharged on dialysis, the MAKE 365 incidence was 52.4%.
Conclusion
COVID-19-associated AKI was associated with high mortality, was associated with worse long-term post-AKI kidney function recovery and MAKE outcomes.