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


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

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Journal of the American Society of Nephrology





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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).


Epidemiology | Nephrology



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