Risk factors for the development of acute kidney injury in patients with COVID-19 pneumonia receiving ICU care

Objective: The present study aimed to investigate the role of factors affecting critical and severe COVID-19 pneumonia in patients with and without acute kidney injury (AKI) who were followed up in the intensive care unit (ICU). Design: Retrospective study Setting: Ataturk Chest Diseases and Chest Surgery Education and Research Hospital Subjects: Three hundred and twenty-one critical and severe COVID-19 patients who were followed up in ICU were retrospectively evaluated in terms of AKI and one -month independent mortality. Interventions : Critical and severe COVID-19 pneumonia Main outcome measures : Serum troponin, D-dimer, ProCT, C -reactive protein, glomerular filtration rate (GFR), uric acid, albumin, LDH, IgA, IgM, IgG, CBC, creatinine, and 48 -hour urine creatinine levels were assessed and short-term (30 day) independent mortality. Results: Short-term (30 -day) mortality occurred in 146 (45.5%) patients, among whom 55 (19.5%) had AKI. In patients with AKI, the APACHE II and SOFA scores and the ferritin, troponin, 48 -hour urine creatinine, uric acid, and LDH levels were significantly higher ( P <0.05), whereas age and GFR values were significantly lower ( P =0.017 and P <0.001, respectively). Multiple logistic regression analysis indicated that the presence of AKI and elevated 48 -hour urine creatinine levels increased the risk of ICU admission by 1.257 (odds ratio [OR]: 1.357) and 3.986 times (OR: 3.986), respectively. Conclusions: Based on our findings, we suggest that monitoring renal function and serum ferritin, troponin, LDH and GFR levels during the first 48 hours and then at regular intervals can help reduce mortality in these patients.