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Jakopin E, Knehtl M, Hojs NV, Bevc S, Piko N, Hojs R, Ekart R. Treatment of acute kidney injury with continuous renal replacement therapy and cytokine adsorber (CytoSorb®) in critically ill patients with COVID-19. Ther Apher Dial 2024. [PMID: 38958006 DOI: 10.1111/1744-9987.14182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION This retrospective study aimed to evaluate the 30 and 60-day survival of critically ill patients with COVID-19 and AKI. METHODS Inflammatory and biochemical biomarkers, length of intensive care unit (ICU) stay and mortality at Day 30 and Day 60 after ICU admission were analyzed. A total of 44 patients treated with continuous renal replacement therapy (CRRT) with cytokine adsorber (CA group) were compared to 58 patients treated with CRRT alone (non-CA group). RESULTS Patients in CA group were younger, had better preserved kidney function prior to the beginning of CRRT and had higher levels of interleukin-6. There were no statistically significant differences in their comorbidities and in other measured biomarkers between the two groups. The number of patients who died 60 days after ICU admission was statistically significantly higher in non-CA group (p = 0.029). CONCLUSION Treatment with CRRT and cytokine adsorber may have positively influenced 60-day survival in our COVID-19 ICU patients with AKI.
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Affiliation(s)
- Eva Jakopin
- Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia
| | - Maša Knehtl
- Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia
| | - Nina Vodošek Hojs
- Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia
| | - Sebastjan Bevc
- Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia
- Medical Faculty, University of Maribor, Maribor, Slovenia
| | - Nejc Piko
- Department of Dialysis, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia
| | - Radovan Hojs
- Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia
- Medical Faculty, University of Maribor, Maribor, Slovenia
| | - Robert Ekart
- Medical Faculty, University of Maribor, Maribor, Slovenia
- Department of Dialysis, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia
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Zacchetti L, Brivio M, Mezzapesa M, Martinelli A, Punzi V, Monti M, Marchesi F, Scarpa L, Zangari R, Longhi L, Raimondi F, Novelli L, Gritti P, Grazioli L, Villa G, Lorini LF. The Effect of Positive Pressure Ventilation on Acute Kidney Injury in COVID-19 Patients with Acute Respiratory Distress Syndrome: An Observational Study. Blood Purif 2024; 53:396-404. [PMID: 38402859 DOI: 10.1159/000536285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/11/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION Acute kidney injury (AKI) is frequent in critically ill COVID-19 patients and is associated with a higher mortality risk. By increasing intrathoracic pressure, positive pressure ventilation (PPV) may reduce renal perfusion pressure by reducing venous return to the heart or by increasing renal venous congestion. This study's aim was to evaluate the association between AKI and haemodynamic and ventilatory parameters in COVID-19 patients with ARDS. METHODS This is a single-centre retrospective observational study. Consecutive patients diagnosed with COVID-19 who met ARDS criteria and required invasive mechanical ventilation were enrolled. The relationship between respiratory and haemodynamic parameters influenced by PPV and AKI development was evaluated. AKI was defined according to KDIGO criteria. AKI recovery was evaluated a month after ICU admission and patients were classified as "recovered," if serum creatinine (sCr) value returned to baseline, or as having "acute kidney disease" (AKD), if criteria for AKI stage 1 or greater persisted. The 6-month all-cause mortality was collected. RESULTS A total of 144 patients were included in the analysis. AKI occurred in 69 (48%) patients and 26 (18%) required renal replacement therapy. In a multivariate logistic regression analysis, sex, hypertension, cumulative dose of furosemide, fluid balance, and plateau pressure were independently associated with AKI. Mortality at 6 months was 50% in the AKI group and 32% in the non-AKI group (p = 0.03). Among 36 patients who developed AKI and were discharged alive from the hospital, 56% had a full renal recovery after a month, while 14%, 6%, and 14% were classified as having an AKD of stage 0, 2, and 3, respectively. CONCLUSIONS In our cohort, AKI was independently associated with multiple variables, including high plateau pressure, suggesting a possible role of PPV on AKI development. Further studies are needed to clarify the role of mechanical ventilation on renal function.
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Affiliation(s)
- Lucia Zacchetti
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Matteo Brivio
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Mario Mezzapesa
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Alessandra Martinelli
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Veronica Punzi
- Department of Anesthesia and Critical Care Medicine, University of Milan, Milan, Italy
| | - Martina Monti
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
- Department of Anesthesia and Critical Care Medicine, University of Milan, Milan, Italy
| | - Federica Marchesi
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Laura Scarpa
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Rosalia Zangari
- FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Luca Longhi
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Federico Raimondi
- Pulmonary Medicine Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Luca Novelli
- Pulmonary Medicine Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Paolo Gritti
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Lorenzo Grazioli
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Gianluca Villa
- Department of Health Sciences, Section of Anesthesiology, Intensive Care and Pain Medicine, University of Florence, Florence, Italy,
- Department of Anesthesia and Intensive Care, Section of Oncological Anesthesia and Intensive Care, Azienda Ospedaliera Universitaria Careggi, Florence, Italy,
| | - Luca Ferdinando Lorini
- Department of Anesthesia, Emergency and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
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Alobaidy ASH, Elhelaly M, Amer ME, Shemies RS, Othman AI, El-Missiry MA. Angiotensin converting enzyme 2 gene expression and markers of oxidative stress are correlated with disease severity in patients with COVID-19. Mol Biol Rep 2023:10.1007/s11033-023-08515-0. [PMID: 37222866 DOI: 10.1007/s11033-023-08515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/10/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Oxidative stress is thought to play a significant role in the pathogenesis and severity of COVID-19. Additionally, angiotensin converting enzyme 2 (ACE2) expression may predict the severity and clinical course of COVID-19. Accordingly, the aim of the present study was to evaluate the association of oxidative stress and ACE2 expression with the clinical severity in patients with COVID-19. METHODS AND RESULTS The present study comprised 40 patients with COVID-19 and 40 matched healthy controls, recruited between September 2021 and March 2022. ACE 2 expression levels were measured using Hera plus SYBR Green qPCR kits with GAPDH used as an internal control. Serum melatonin (MLT) levels, serum malondialdehyde (MDA) levels, and total antioxidant capacity (TAC) were estimated using ELISA. The correlations between the levels of the studied markers and clinical indicators of disease severity were evaluated. Significantly, lower expression of ACE2 was observed in COVID-19 patients compared to controls. Patients with COVID-19 had lower serum levels of TAC and MLT but higher serum levels of MDA compared to normal controls. Serum MDA levels were correlated with diastolic blood pressure (DBP), Glasgow coma scale (GCS) scores, and serum potassium levels. Serum MLT levels were positively correlated with DBP, mean arterial pressure (MAP), respiratory rate, and serum potassium levels. TAC was correlated with GCS, mean platelet volume, and serum creatinine levels. Serum MLT levels were significantly lower in patients treated with remdesivir and inotropes. Receiver operating characteristic curve analysis demonstrates that all markers had utility in discriminating COVID-19 patients from healthy controls. CONCLUSIONS Increased oxidative stress and increased ACE2 expression were correlated with disease severity and poor outcomes in hospitalized patients with COVID-19 in the present study. Melatonin supplementation may provide a utility as an adjuvant therapy in decreasing disease severity and death in COVID-19 patients.
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Affiliation(s)
- Afraa S H Alobaidy
- Zoology Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Mona Elhelaly
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Maggie E Amer
- Zoology Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Rasha S Shemies
- Mansoura Nephrology and Dialysis Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Azza I Othman
- Zoology Department, Faculty of Science, Mansoura University, Mansoura, Egypt
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González-Soria I, Soto-Valadez AD, Martínez-Rojas MA, Ortega-Trejo JA, Pérez-Villalva R, Gamba G, Sánchez-Navarro A, Bobadilla NA. SerpinA3K Deficiency Reduces Oxidative Stress in Acute Kidney Injury. Int J Mol Sci 2023; 24:ijms24097815. [PMID: 37175519 PMCID: PMC10177890 DOI: 10.3390/ijms24097815] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023] Open
Abstract
We previously showed that SerpinA3K is present in urine from rats and humans with acute kidney injury (AKI) and chronic kidney disease (CKD). However, the specific role of SerpinA3K during renal pathophysiology is unknown. To begin to understand the role of SerpinA3K on AKI, SerpinA3K-deficient (KOSA3) mice were studied 24 h after inducing ischemia/reperfusion (I/R) and compared to wild type (WT) mice. Four groups were studied: WT+S, WT+IR, KOSA3+S, and KOSA3+IR. As expected, I/R increased serum creatinine and BUN, with a GFR reduction in both genotypes; however, renal dysfunction was ameliorated in the KOSA3+IR group. Interestingly, the increase in UH2O2 induced by I/R was not equally seen in the KOSA3+IR group, an effect that was associated with the preservation of antioxidant enzymes' mRNA levels. Additionally, FOXO3 expression was initially greater in the KOSA3 than in the WT group. Moreover, the increase in BAX protein level and the decrease in Hif1a and Vegfa induced by I/R were not observed in the KOSA3+IR group, suggesting that these animals have better cellular responses to hypoxic injury. Our findings suggest that SerpinA3K is involved in the renal oxidant response, HIF1α/VEGF pathway, and cell apoptosis.
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Affiliation(s)
- Isaac González-Soria
- Molecular Physiology Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
- PECEM (MD/PhD), Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Axel D Soto-Valadez
- Molecular Physiology Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
| | - Miguel Angel Martínez-Rojas
- Molecular Physiology Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
| | - Juan Antonio Ortega-Trejo
- Molecular Physiology Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
| | - Rosalba Pérez-Villalva
- Molecular Physiology Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Gerardo Gamba
- Molecular Physiology Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
| | - Andrea Sánchez-Navarro
- Molecular Physiology Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Norma A Bobadilla
- Molecular Physiology Unit, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
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Nogueira GM, Silva NLOR, Moura AF, Duarte Silveira MA, Moura-Neto JA. Acute kidney injury and electrolyte disorders in COVID-19. World J Virol 2022; 11:283-292. [PMID: 36188735 PMCID: PMC9523327 DOI: 10.5501/wjv.v11.i5.283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/30/2022] [Accepted: 08/22/2022] [Indexed: 02/05/2023] Open
Abstract
Acute kidney injury (AKI) and electrolyte disorders are important complications of hospitalized coronavirus disease 2019 (COVID-19) patients. AKI is thought to occur due to multiple pathophysiological mechanisms, such as multiple organ dysfunction (mainly cardiac and respiratory), direct viral entry in the renal tubules, and cytokine release syndrome. AKI is present in approximately one in every ten hospitalized COVID-19 patients. The incidence rates of AKI increase in patients who are admitted to the intensive care unit (ICU), with levels higher than 50%. Additionally, renal replacement therapy (RRT) is used in 7% of all AKI cases, but in nearly 20% of patients admitted to an ICU. COVID-19 patients with AKI are considered moderate-to-severe cases and are managed with multiple interdisciplinary conducts. AKI acts as a risk factor for mortality in severe acute respiratory syndrome coronavirus 2 infection, especially when RRT is needed. Electrolyte disorders are also common manifestations in hospitalized COVID-19 patients, mainly hyponatremia, hypokalemia, and hypocalcemia. Hyponatremia occurs due to a combination of syndrome of inappropriate secretion of antidiuretic hormone and gastrointestinal fluid loss from vomiting and diarrhea. When it comes to hypokalemia, its mechanism is not fully understood but may derive from hyperaldosteronism due to renin angiotensin aldosterone system overstimulation and gastrointestinal fluid loss as well. The clinical features of hypokalemia in COVID-19 are similar to those in other conditions. Hypocalcemia is the most common electrolyte disorder in COVID-19 and seems to occur because of vitamin D deficiency and parathyroid imbalance. It is also highly associated with longer hospital and ICU stay.
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Affiliation(s)
- Gabriel Martins Nogueira
- Department of Medicine, Bahiana School of Medicine and Public Health, Salvador 40290-000, Bahia, Brazil
| | | | - Ana Flávia Moura
- Department of Medicine, Bahiana School of Medicine and Public Health, Salvador 40290-000, Bahia, Brazil
| | | | - José A Moura-Neto
- Department of Medicine, Bahiana School of Medicine and Public Health, Salvador 40290-000, Bahia, Brazil
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Carnitine Deficiency after Long-Term Continuous Renal Replacement Therapy. Case Rep Crit Care 2022; 2022:4142539. [PMID: 36035086 PMCID: PMC9402317 DOI: 10.1155/2022/4142539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
A 60-year-old man was admitted in the intensive care unit (ICU) for a rapidly progressive respiratory failure due to SARS-CoV-2 infection. He developed numerous complications including acute kidney injury (AKI) requiring prolonged continuous renal replacement therapy (CRRT). Enteral feeding was initiated on day 8. Despite nutritional management, there was a remarkable amyotrophy and weight loss. On day 85 in the ICU, the patient became progressively unresponsive. An extensive metabolic workup was performed, and blood results showed hyperammoniemia and hypertriglyceridemia. Plasma free carnitine level was low, as was also copper. After carnitine supplementation, the neurological condition rapidly improved, and metabolic perturbations regressed. Prolonged CRRT may be complicated by clinically significant deficiency in micronutrients and trace elements.
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Oweis AO, Alshelleh SA, Hawasly L, Alsabbagh G, Alzoubi KH. Acute Kidney Injury among Hospital-Admitted COVID-19 Patients: A Study from Jordan. Int J Gen Med 2022; 15:4475-4482. [PMID: 35518517 PMCID: PMC9064179 DOI: 10.2147/ijgm.s360834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/11/2022] [Indexed: 12/24/2022] Open
Abstract
Objective During the COVID-19 pandemic, many patients have been admitted to hospitals with severe respiratory disease and suffered complications. Acute kidney injury (AKI) is among the more dangerous complications contributing to morbidity and mortality among patients. Methods This retrospective study focused on all hospital-admitted COVID-19 patients between September and December 2020. A total of 1,044 patients were enrolled. Patient demographics, medical records, and laboratory data were gathered. Patients were split into two groups: AKI and non-AKI. Comparisons comprised demographics, labs, ICU transfer, need for ventilation and oxygen therapy, medications, hospital stay, and deaths. Results AKI incidence in the cohort was 25.3%, and a majority were stage 1 (53.3%). Among these, hemodialysis was started in 1.8%. Higher age (P<0.001), diabetes mellitus (P=0.001), hypertension (P=0.001), ACEI/ARB use (P=0.008), erythrocyte-sedimentation rate (P=0.002), CRP (P<0.0001), and ferritin (P=0.01) were predictors of AKI. Among all admitted COVID-19 patients, 30.2% died in hospital. Among those with AKI, 75.9% died in comparison to 24.1% of non-AKI patients (P<0.001). Among COVID-19 patients admitted to the ICU, 80.5% died: 70.5% were from the AKI group and 29.5% from the non-AKI group (P<0.001). Conclusion High mortality and morbidity is associated with COVID-19 infection, and AKI is contributing significantly to the outcomes of hospitalized patients with the infection. Early recognition of and treatment for AKI will decrease mortality and hospitalization in patients with COVID-19.
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Affiliation(s)
- Ashraf O Oweis
- Department of Internal Medicine, Nephrology Division, Jordan University of Science and Technology, Irbid, Jordan
| | - Sameeha A Alshelleh
- Department of Internal Medicine, Nephrology Division, University of Jordan, Amman, Jordan
| | - Lubna Hawasly
- Department of Internal Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ghalia Alsabbagh
- Department of Internal Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Bayrakci N, Özkan G, Şakaci M, Sedef S, Erdem İ, Tuna N, Mutlu LC, Yildirim İ, Kiraz N, Erdal B, Gelgeç E, Erer A, Saraç Ö, Yavuz A, Dolap U, Hayri UB, Kocadelioğlu İ, Batmaz E. The incidence of acute kidney injury and its association with mortality in patients diagnosed with COVID-19 followed up in intensive care unit. Ther Apher Dial 2022; 26:889-896. [PMID: 34990070 DOI: 10.1111/1744-9987.13790] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/07/2021] [Accepted: 12/31/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The kidneys are some of the most frequently affected organs during coronavirus disease 2019 (COVID-19). This multicenter study evaluated the incidence of and risk factors for acute kidney injury (AKI) in COVID-19 patients followed up in intensive care unit (ICU) and its association with mortality. METHODS Three hundred twenty-eight patients diagnosed with COVID-19 and hospitalized in ICU were included. Risk factors associated with AKI and mortality were evaluated. RESULTS Eighty-eight patients (27.9%) were diagnosed with AKI. AKI was significantly associated with older age, higher baseline creatinine level, lower albumin level, and coexistence of cardiovascular disease and chronic obstructive pulmonary disease. Mortality in the entire study group was significantly associated with AKI, older age, requirement of invasive mechanical ventilation, higher neutrophil level, lower lymphocyte, and albumin levels. CONCLUSION AKI is frequently seen during the course of COVID-19 and is associated with high mortality. Identifying AKI-related risk factors appears essential in the management of COVID-19 patients.
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Affiliation(s)
- Nergiz Bayrakci
- Department of Nephrology, School of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - Gülsüm Özkan
- Department of Nephrology, School of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - Murat Şakaci
- Department of Nephrology, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
| | - Samet Sedef
- Department of Internal Medicine, Tekirdag City Hospital, Tekirdag, Turkey
| | - İlknur Erdem
- Department of Infectious Diseases, School of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - Nazan Tuna
- Department of Infectious Diseases, School of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - Levent Cem Mutlu
- Department of Pulmonary Medicine, School of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - İlker Yildirim
- Department of Anesthesiology and Reanimation, School of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - Nuri Kiraz
- Department of Microbiology, School of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - Berna Erdal
- Department of Microbiology, School of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - Ebru Gelgeç
- Department of Anesthesiology and Reanimation, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
| | - Ayşen Erer
- Department of Anesthesiology and Reanimation, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
| | - Ömürhan Saraç
- Department of Anesthesiology and Reanimation, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
| | - Ahmet Yavuz
- Department of Nephrology, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
| | - Uysal Dolap
- Department of Pulmonary Medicine, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
| | - Uluğ Bey Hayri
- Department of Pulmonary Medicine, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
| | - İnci Kocadelioğlu
- Department of Pulmonary Medicine, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
| | - Emrah Batmaz
- Department of Pulmonary Medicine, Tekirdag Dr. İsmail Fehmi Cumalioglu City Hospital, Tekirdag, Turkey
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Shemies RS, Nagy E, Younis D, Sheashaa H. Renal replacement therapy for critically ill patients with COVID-19-associated acute kidney injury: A review of current knowledge. Ther Apher Dial 2021; 26:15-23. [PMID: 34378870 PMCID: PMC8420218 DOI: 10.1111/1744-9987.13723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/02/2021] [Accepted: 08/09/2021] [Indexed: 01/08/2023]
Abstract
The outbreak of coronavirus disease 2019 (COVID‐19) has rapidly evolved into a global pandemic. A significant proportion of COVID‐19 patients develops severe symptoms, which may include acute respiratory distress syndrome and acute kidney injury as manifestations of multi‐organ failure. Acute kidney injury (AKI) necessitating renal replacement therapy (RRT) is increasingly prevalent among critically ill patients with COVID‐19. However, few studies have focused on AKI treated with RRT. Many questions are awaiting answers as regards AKI in the setting of COVID‐19; whether patients with COVID‐19 commonly develop AKI, what are the underlying pathophysiologic mechanisms? What is the best evidence regarding treatment approaches? Identification of the potential indications and the preferred modalities of RRT in this context, is based mainly on clinical experience. Here, we review the current approaches of RRT, required for management of critically ill patients with COVID‐19 complicated by severe AKI as well as the precautions that should be adopted by health care providers in dealing with these cases. Electronic search was conducted in MEDLINE, PubMed, ISI Web of Science, and Scopus scientific databases. We searched the terms relevant to this review to identify the relevant studies. We also searched the conference proceedings and ClinicalTrials.gov database.
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Affiliation(s)
| | - Eman Nagy
- Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura, Egypt
| | - Dalia Younis
- Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura, Egypt
| | - Hussein Sheashaa
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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