TY - JOUR
T1 - Incidence, risk factors and outcome of acute kidney injury in critically ill COVID-19 patients in Tyrol, Austria
T2 - a prospective multicenter registry study
AU - Mayerhöfer, Timo
AU - Perschinka, Fabian
AU - Klein, Sebastian J
AU - Peer, Andreas
AU - Lehner, Georg F
AU - Bellmann, Romuald
AU - Gasteiger, Lukas
AU - Mittermayr, Markus
AU - Breitkopf, Robert
AU - Eschertzhuber, Stephan
AU - Mathis, Simon
AU - Fiala, Anna
AU - Fries, Dietmar
AU - Ströhle, Mathias
AU - Foidl, Eva
AU - Hasibeder, Walter
AU - Helbok, Raimund
AU - Kirchmair, Lukas
AU - Stögermüller, Birgit
AU - Krismer, Christoph
AU - Heiner, Tatjana
AU - Ladner, Eugen
AU - Thomé, Claudius
AU - Preuß-Hernandez, Christian
AU - Mayr, Andreas
AU - Potocnik, Miriam
AU - Reitter, Bruno
AU - Brunner, Jürgen
AU - Zagitzer-Hofer, Stefanie
AU - Ribitsch, Alexandra
AU - Joannidis, Michael
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - 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.
AB - 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.
KW - Critical care
KW - Intensive Care Unit
KW - Pandemic
KW - Renal
KW - SARS-CoV-2
KW - Intensive Care Units
KW - Pandemics
KW - COVID-19/complications
KW - Humans
KW - Risk Factors
KW - Critical Illness/therapy
KW - Respiration, Artificial
KW - Incidence
KW - Austria/epidemiology
KW - Adult
KW - Acute Kidney Injury/epidemiology
KW - Aged
KW - Retrospective Studies
UR - http://www.scopus.com/inward/record.url?scp=85174189989&partnerID=8YFLogxK
U2 - 10.1007/s40620-023-01760-3
DO - 10.1007/s40620-023-01760-3
M3 - Journal article
C2 - 37837501
SN - 1121-8428
VL - 36
SP - 2531
EP - 2540
JO - Journal of Nephrology
JF - Journal of Nephrology
IS - 9
ER -