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 Krismer; Tatjana Heiner; Eugen Ladner; Claudius Thomé; Christian Preuß-Hernandez; Andreas Mayr; Miriam Potocnik; Bruno Reitter; Jürgen Brunner; Stefanie Zagitzer-Hofer; Alexandra Ribitsch; Michael Joannidis

doi:10.1007/s40620-023-01760-3

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 Krismer

Tatjana Heiner, Eugen Ladner, Claudius Thomé, Christian Preuß-Hernandez, Andreas Mayr, Miriam Potocnik, Bruno Reitter, Jürgen Brunner, Stefanie Zagitzer-Hofer, Alexandra Ribitsch, Michael Joannidis

Division of Internal Medicine 2 (University Hospital St. Pölten)

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

10 Citations (Scopus)

Abstract

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 language	English
Pages (from-to)	2531-2540
Number of pages	10
Journal	Journal of Nephrology
Volume	36
Issue number	9
Early online date	14 Oct 2023
DOIs	https://doi.org/10.1007/s40620-023-01760-3
Publication status	Published - Dec 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Critical care
Intensive Care Unit
Pandemic
Renal
SARS-CoV-2
Intensive Care Units
Pandemics
COVID-19/complications
Humans
Risk Factors
Critical Illness/therapy
Respiration, Artificial
Incidence
Austria/epidemiology
Adult
Acute Kidney Injury/epidemiology
Aged
Retrospective Studies

ASJC Scopus subject areas

Nephrology

Access to Document

10.1007/s40620-023-01760-3

Cite this

Mayerhöfer, T., Perschinka, F., Klein, S. J., Peer, A., Lehner, G. F., Bellmann, R., Gasteiger, L., Mittermayr, M., Breitkopf, R., Eschertzhuber, S., Mathis, S., Fiala, A., Fries, D., Ströhle, M., Foidl, E., Hasibeder, W., Helbok, R., Kirchmair, L., Stögermüller, B., ... Joannidis, M. (2023). Incidence, risk factors and outcome of acute kidney injury in critically ill COVID-19 patients in Tyrol, Austria: a prospective multicenter registry study. Journal of Nephrology, 36(9), 2531-2540. https://doi.org/10.1007/s40620-023-01760-3

@article{3343a1ab573646cd846926597274326d,

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

abstract = "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.",

keywords = "Critical care, Intensive Care Unit, Pandemic, Renal, SARS-CoV-2, Intensive Care Units, Pandemics, COVID-19/complications, Humans, Risk Factors, Critical Illness/therapy, Respiration, Artificial, Incidence, Austria/epidemiology, Adult, Acute Kidney Injury/epidemiology, Aged, Retrospective Studies",

author = "Timo Mayerh{\"o}fer and Fabian Perschinka and Klein, \{Sebastian J\} and Andreas Peer and Lehner, \{Georg F\} and Romuald Bellmann and Lukas Gasteiger and Markus Mittermayr and Robert Breitkopf and Stephan Eschertzhuber and Simon Mathis and Anna Fiala and Dietmar Fries and Mathias Str{\"o}hle and Eva Foidl and Walter Hasibeder and Raimund Helbok and Lukas Kirchmair and Birgit St{\"o}germ{\"u}ller and Christoph Krismer and Tatjana Heiner and Eugen Ladner and Claudius Thom{\'e} and Christian Preu{\ss}-Hernandez and Andreas Mayr and Miriam Potocnik and Bruno Reitter and J{\"u}rgen Brunner and Stefanie Zagitzer-Hofer and Alexandra Ribitsch and Michael Joannidis",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = dec,

doi = "10.1007/s40620-023-01760-3",

language = "English",

volume = "36",

pages = "2531--2540",

journal = "Journal of Nephrology",

issn = "1121-8428",

publisher = "Oxford University Press",

number = "9",

}

Mayerhöfer, T, Perschinka, F, Klein, SJ, Peer, A, Lehner, GF, Bellmann, R, Gasteiger, L, Mittermayr, M, Breitkopf, R, Eschertzhuber, S, Mathis, S, Fiala, A, Fries, D, Ströhle, M, Foidl, E, Hasibeder, W, Helbok, R, Kirchmair, L, Stögermüller, B, Krismer, C, Heiner, T, Ladner, E, Thomé, C, Preuß-Hernandez, C, Mayr, A, Potocnik, M, Reitter, B, Brunner, J, Zagitzer-Hofer, S, Ribitsch, A & Joannidis, M 2023, 'Incidence, risk factors and outcome of acute kidney injury in critically ill COVID-19 patients in Tyrol, Austria: a prospective multicenter registry study', Journal of Nephrology, vol. 36, no. 9, pp. 2531-2540. https://doi.org/10.1007/s40620-023-01760-3

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

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 - https://www.scopus.com/pages/publications/85174189989

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 -

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

Abstract

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this