Burke E, Haber E, Pike CW, Sonti R. Outcomes of renal replacement therapy in the critically ill with COVID-19.
Med Intensiva 2021;
45:325-331. [PMID:
34294231 PMCID:
PMC8294005 DOI:
10.1016/j.medine.2021.02.006]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/09/2021] [Indexed: 01/08/2023]
Abstract
Objective
To describe outcomes of critically ill patients with COVID-19, particularly the association of renal replacement therapy to mortality.
Design
A single-center prospective observational study was carried out.
Setting
ICU of a tertiary care center.
Patients
Consecutive adults with COVID-19 admitted to the ICU.
Intervention
Renal replacement therapy.
Main variables of interest
Demographic data, medical history, illness severity, type of oxygen therapy, laboratory data and use of renal replacement therapy to generate a logistic regression model describing independent risk factors for mortality.
Results
Of the total of 166 patients, 51% were mechanically ventilated and 26% required renal replacement therapy. The overall hospital mortality rate was 36%, versus 56% for those requiring renal replacement therapy, and 68% for those with both mechanical ventilation and renal replacement therapy. The logistic regression model identified four independent risk factors for mortality: age (adjusted OR 2.8 [95% CI 1.8–4.4] for every 10-year increase), mechanical ventilation (4.2 [1.7–10.6]), need for continuous venovenous hemofiltration (2.3 [1.3–4.0]) and C-reactive protein (1.1 [1.0–1.2] for every 10 mg/L increase).
Conclusions
In our cohort, acute kidney injury requiring renal replacement therapy was associated to a high mortality rate similar to that associated to the need for mechanical ventilation, while multiorgan failure necessitating both techniques implied an extremely high mortality risk.
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