Frontiers in Medicine (Jun 2021)

Acute Kidney Injury Due to COVID-19 in Intensive Care Unit: An Analysis From a Latin-American Center

  • Precil Diego Miranda de Menezes Neves,
  • Precil Diego Miranda de Menezes Neves,
  • Victor Augusto Hamamoto Sato,
  • Sara Mohrbacher,
  • Bernadete Maria Coelho Ferreira,
  • Érico Souza Oliveira,
  • Leonardo Victor Barbosa Pereira,
  • Alessandra Martins Bales,
  • Luciana Loureiro Nardotto,
  • Jéssica Nogueira Ferreira,
  • David José Machado,
  • David José Machado,
  • Estêvão Bassi,
  • Amilton Silva-Júnior,
  • Pedro Renato Chocair,
  • Américo Lourenço Cuvello-Neto

DOI
https://doi.org/10.3389/fmed.2021.620050
Journal volume & issue
Vol. 8

Abstract

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Introduction: The kidney may be affected by coronavirus (COVID-19) in the setting of acute kidney injury (AKI). Data about AKI in intensive care unit (ICU) patients in Latin America are scarce. We aimed to evaluate the risk of AKI, dialysis (HD), and death in ICU COVID-19 patients in a Brazilian center.Methods: Analysis from medical records of COVID-19 patients in a Brazilian center.Results: A total of 95 patients were analyzed. There was male predominance (64.2%), median age: 64.9 years, and previous history of hypertension and diabetes in 51.6 and 27.4%, respectively. AKI was diagnosed in 54 (56.8%) patients, and 32 (59.2%) of them required HD. Mortality rate was 17.9%. AKI patients when compared with no-AKI were more frequently hypertensive/diabetic and more often needed organ support therapies. Workups depicted more anemia, lymphopenia, and higher levels of inflammatory markers and higher mortality. Comparing patients who had undergone death to survivors, they were older, more frequently diabetic, and had worse SAPS3 and SOFA scores and need for organ support therapies, AKI, and HD. Multinomial logistic regression revealed that hypertension (p = 0.018) and mechanical ventilation (p = 0.002) were associated with AKI; hypertension (p = 0.002), mechanical ventilation (p = 0.008), and use of vasopressor (p = 0.027) to HD patients; and age >65 years (p = 0.03) and AKI (p = 0.04) were risk factors for death.Conclusions: AKI was a common complication of ICU COVID-19 patients, and it was more frequent in patients with hypertension and need of organ support therapies. As well as age >65 years, AKI was an independent risk factor for death.

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