AKI Treated with Renal Replacement Therapy in Critically Ill Patients with COVID-19

Authors

• Shruti Gupta, Brigham and Women’s Hospital
• Steven G. Coca, Icahn School of Medicine at Mount Sinai
• Lili Chan, Icahn School of Medicine at Mount Sinai
• Michael L. Melamed, Montefiore Medical Center/Albert Einstein College of Medicine
• Samatha K. Brenner, Hackensack Meridian School of Medicine
• Salim S. Hayek, University of Michigan Medical Center
• Anne Sutherland, Rutgers New Jersey Medical School
• Sonika Puri, Rutgers Robert Wood Johnson Medical School
• Anand Srivastava, Northwestern University Feinberg School of Medicine
• Amanda Leonberg-Yoo, University of Pennsylvania
• Alexandre M. Shehata, Meridian Health Mountainside Medical Center
• Jennifer E. Flythe, University of North Carolina School of Medicine
• Arash Rashidi, University Hospitals Cleveland Medical Center
• Edward J. Schenck, Weill Cornell Medicine
• Nitender Goyal, Tufts Medical Center
• S. Susan Hedayati, University of Texas Southwestern Medical Center
• Rajany Dy, University of Nevada, Las VegasFollow
• Anip Bansal, University of Colorado Anschutz Medical Campus
• Ambarish Athavale, Cook County Health
• H. Bryant Nguyen, Loma Linda University Health
• Anitha Vijayan, Washington University
• David M. Charytan, New York University Grossman School of Medicine
• Carl E. Schulze, University of California, Los Angeles
• Min J. Joo, University of Illinois
• Allon N. Friedman, Indiana University School of Medicine
• Jingjing Zhang, Thomas Jefferson University Hospital
• Marie Anne Sosa, University of Miami Miller School of Medicine and Jackson Memorial Hospital
• Eric Judd, University of Alabama at Birmingham
• Juan Carlos Q. Velez, Ochsner Health System
• Mary Mallappallil, New York City Health and Hospital Corporation
• Roberta E. Redfern, ProMedica Toledo Hospital

Document Type

Article

Publication Date

1-1-2021

Publication Title

Journal of the American Society of Nephrology

Volume

32

Issue

1

First page number:

161

Last page number:

176

Abstract

Background: AKI is a common sequela of coronavirus disease 2019 (COVID-19). However, few studies have focused on AKI treated with RRT (AKI-RRT). Methods: We conducted a multicenter cohort study of 3099 critically ill adults with COVID-19 admitted to intensive care units (ICUs) at 67 hospitals across the United States. We used multivariable logistic regression to identify patient-and hospital-level risk factors for AKI-RRT and to examine risk factors for 28-day mortality among such patients. Results: A total of 637 of 3099 patients (20.6%) developed AKI-RRT within 14 days of ICU admission, 350 of whom (54.9%) died within 28 days of ICU admission. Patient-level risk factors for AKI-RRT included CKD, men, non-White race, hypertension, diabetes mellitus, higher body mass index, higher d-dimer, and greater severity of hypoxemia on ICU admission. Predictors of 28-day mortality in patients with AKI-RRT were older age, severe oliguria, and admission to a hospital with fewer ICU beds or one with greater regional density of COVID-19. At the end of a median follow-up of 17 days (range, 1–123 days), 403 of the 637 patients (63.3%) with AKI-RRT had died, 216 (33.9%) were discharged, and 18 (2.8%) remained hospitalized. Of the 216 patients discharged, 73 (33.8%) remained RRT dependent at discharge, and 39 (18.1%) remained RRT dependent 60 days after ICU admission. Conclusions: AKI-RRT is common among critically ill patients with COVID-19 and is associated with a hospital mortality rate of... (See full abstract in article).

Disciplines

Epidemiology | Nephrology

Language

English

Repository Citation

Gupta, S., Coca, S. G., Chan, L., Melamed, M. L., Brenner, S. K., Hayek, S. S., Sutherland, A., Puri, S., Srivastava, A., Leonberg-Yoo, A., Shehata, A. M., Flythe, J. E., Rashidi, A., Schenck, E. J., Goyal, N., Hedayati, S. S., Dy, R., Bansal, A., Athavale, A., Nguyen, H. B., Vijayan, A., Charytan, D. M., Schulze, C. E., Joo, M. J., Friedman, A. N., Zhang, J., Sosa, M. A., Judd, E., Velez, J. Q., Mallappallil, M., Redfern, R. E. (2021). AKI Treated with Renal Replacement Therapy in Critically Ill Patients with COVID-19. Journal of the American Society of Nephrology, 32(1), 161-176.
http://dx.doi.org/10.1681/ASN.2020060897