Background Acute kidney injury (AKI) is a common manifestation among patients critically ill with SARS-CoV-2 infection (Coronavirus 2019) and is associated with significant morbidity and mortality. The pathophysiology of renal failure in this context is not fully understood, but likely to be multifactorial. The intensive care unit outcomes of patients following COVID-19 acute critical illness with associated AKI have not been fully explored. We conducted a cohort study to investigate the risk factors for acute kidney injury in patients admitted to and intensive care unit with COVID-19, its incidence and associated outcomes. Methods We reviewed the medical records of all patients admitted to our adult intensive care unit suffering from SARS-CoV-2 infection from 14th March 2020 until 12th May 2020. Acute kidney injury was defined using the Kidney Disease Improving Global Outcome (KDIGO) criteria. The outcome analysis was assessed up to date as 3rd of September 2020. Results A total of 81 patients admitted during this period. All patients had acute hypoxic respiratory failure and needed either noninvasive or invasive mechanical ventilatory support. Thirty-six patients (44%) had evidence of AKI (Stage I-33%, Stage II-22%, Renal Replacement Therapy (RRT)-44%). All patients with AKI stage III had RRT. Age, diabetes mellitus, immunosuppression, lymphopenia, high D-Dimer levels, increased APACHE II and SOFA scores, invasive mechanical ventilation and use of inotropic or vasopressor support were significantly associated with AKI. The peak AKI was at day 4 and mean duration of RRT was 12.5 days. The mortality was 25% for the AKI group compared to 6.7% in those without AKI. Among those received RRT and survived their illness, the renal function recovery is complete and back to baseline in all patients. Conclusion Acute kidney injury and renal replacement therapy is common in critically ill patients presenting with COVID-19. It is associated with increased severity of illness on admission to ICU, increased mortality and prolonged ICU and hospital length of stay. Recovery of renal function was complete in all survived patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02296-z.
【저자키워드】 COVID-19, intensive care, Acute kidney injury, 【초록키워드】 Mortality, hypoxic respiratory failure, SARS-COV-2 infection, severity, hospital, Diabetes Mellitus, Immunosuppression, outcome, risk factor, renal function, ICU, cohort study, Kidney injury, lymphopenia, outcomes, AKI, Critically ill, pathophysiology, Patient, morbidity and mortality, incidence, Admission, Critical, patients, renal replacement therapy, Evidence, Invasive mechanical ventilation, noninvasive, APACHE II, criteria, medical record, ventilatory support, Critically ill patient, RRT, supplementary material, Stage, increased mortality, renal, replacement, vasopressor support, KDIGO, stage III, multifactorial, Complete, outcome analysis, SOFA scores, Result, defined, significantly, conducted, presenting, survived, baseline, Improving, invasive mechanical, patients with AKI, with COVID-19, 【제목키워드】 outcome, cohort study, Critically ill, Characteristics, clinical, COVID-19 patient, acute kidney,