Abstract
The outbreak of coronavirus disease 2019 (CO-VID-19) has rapidly evolved into a global pandemic. Kidney dysfunction is common among patients with COVID-19, and patients who develop acute kidney injury (AKI) have inferior outcomes. There is a growing body of evidence that AKI occurs in a substantial number of patients with COVID-19 and that developing AKI is associated with significantly worse outcomes for COVID-19 patients. The risk for death was amplified when AKI resulted in kidney replacement therapy (KRT). Subject of Review: The Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID) conducted a multicenter retrospective observational study enrolling 3,099 critically ill adults with COVID-19 admitted to intensive care units (ICUs) (J Am Soc Nephrol 2021;32:161-176). A total of 637 of 3,099 patients (20.6%) developed AKI treated with KRT (AKI-KRT) within 14 days of ICU admission, 350 of whom (54.9%) died within 28 days of ICU admission. Predictors of COVID-19 patients’ progress to AKI-KRT were higher BMI, higher stages of CKD, lower ratio of the partial pressure of arterial oxygen over the fraction of inspired oxygen (PaO2:FiO2 ratio) on ICU admission, and greater number of vasopressors received on ICU admission. Second Opinion: Recently, some investigations revealed that the independent predictors of COVID-19 with AKI include older age, Black race, diabetes, hypertension, cardiovascular disease, mechanical ventilation, higher interleukin-6 level, and use of vasopressor medications. It seems that the underlying comorbidities with preexisting vascular endothelial damage and/or the more serious critically ill CO-VID-19 patients can contribute to the development of AKI and even AKI-KRT.
Keywords: Acute kidney injury; Coronavirus disease 2019; Endothelial dysfunction; Intensive care unit.
【저자키워드】 Coronavirus disease 2019, intensive care unit, Acute kidney injury, Endothelial dysfunction, 【초록키워드】 COVID-19, coronavirus disease, therapy, mechanical ventilation, intensive care unit, interleukin-6, Comorbidity, risk, cardiovascular disease, oxygen, endothelial damage, diabetes, outcome, medications, hypertension, kidney, global pandemic, outcomes, AKI, Critically ill, outbreak, Patient, Older age, ICU admission, death, multicenter, BMI, disease, Care, COVID-19 patients, Evidence, retrospective, COVID-19 patient, CKD, dysfunction, Vasopressor, Vascular, Black race, Stage, ICUs, fraction, second, greater, amplified, develop, died, significantly, include, conducted, treated, contribute, occur, Ill, independent predictor, patients with COVID-19, STOP-COVID, with COVID-19, 【제목키워드】 Concerned,