Incidence, risk factors and outcome of acute kidney injury in critically ill COVID-19 patients in Tyrol, Austria: a prospective multicenter registry study

Timo Mayerhöfer, Fabian Perschinka, Sebastian J Klein, Andreas Peer, Georg F Lehner, Romuald Bellmann, Lukas Gasteiger, Markus Mittermayr, Robert Breitkopf, Stephan Eschertzhuber, Simon Mathis, Anna Fiala, Dietmar Fries, Mathias Ströhle, Eva Foidl, Walter Hasibeder, Raimund Helbok, Lukas Kirchmair, Birgit Stögermüller, Christoph KrismerTatjana Heiner, Eugen Ladner, Claudius Thomé, Christian Preuß-Hernandez, Andreas Mayr, Miriam Potocnik, Bruno Reitter, Jürgen Brunner, Stefanie Zagitzer-Hofer, Alexandra Ribitsch, Michael Joannidis

Research output: Journal article (peer-reviewed)Journal article


INTRODUCTION: Acute kidney injury is a frequent complication in critically ill patients with and without COVID-19. The aim of this study was to evaluate the incidence of, and risk factors for, acute kidney injury and its effect on clinical outcomes of critically ill COVID-19 patients in Tyrol, Austria.

METHODS: This multicenter prospective registry study included adult patients with a SARS-CoV-2 infection confirmed by polymerase chain reaction, who were treated in one of the 12 dedicated intensive care units during the COVID-19 pandemic from February 2020 until May 2022.

RESULTS: In total, 1042 patients were included during the study period. The median age of the overall cohort was 66 years. Of the included patients, 267 (26%) developed acute kidney injury during their intensive care unit stay. In total, 12.3% (n = 126) required renal replacement therapy with a median duration of 9 (IQR 3-18) days. In patients with acute kidney injury the rate of invasive mechanical ventilation was significantly higher with 85% (n = 227) compared to 41% (n = 312) in the no acute kidney injury group (p < 0.001). The most important risk factors for acute kidney injury were invasive mechanical ventilation (OR = 4.19, p < 0.001), vasopressor use (OR = 3.17, p < 0.001) and chronic kidney disease (OR = 2.30, p < 0.001) in a multivariable logistic regression analysis. Hospital and intensive care unit mortality were significantly higher in patients with acute kidney injury compared to patients without acute kidney injury (Hospital mortality: 52.1% vs. 17.2%, p < 0.001, ICU-mortality: 47.2% vs. 14.7%, p < 0.001).

CONCLUSION: As in non-COVID-19 patients, acute kidney injury is clearly associated with increased mortality in critically ill COVID-19 patients. Among known risk factors, invasive mechanical ventilation has been identified as an independent and strong predictor of acute kidney injury.

Original languageEnglish
JournalJournal of Nephrology
Publication statusE-pub ahead of print - 14 Oct 2023


  • Critical care
  • Intensive Care Unit
  • Pandemic
  • Renal
  • SARS-CoV-2

ASJC Scopus subject areas

  • Nephrology


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