Incidence, risk factors and outcome of acute kidney injury in critically ill COVID-19 patients in Tyrol, Austria: a prospective multicenter registry study

被引：8

作者：

Mayerhoefer, Timo ^{[1
]}

Perschinka, Fabian ^{[1
]}

Klein, Sebastian J. ^{[1
,2
]}

Peer, Andreas ^{[1
]}

Lehner, Georg F. ^{[1
]}

Bellmann, Romuald ^{[1
]}

Gasteiger, Lukas ^{[3
]}

Mittermayr, Markus ^{[3
]}

Breitkopf, Robert ^{[3
]}

Eschertzhuber, Stephan ^{[4
]}

Mathis, Simon ^{[5
]}

Fiala, Anna ^{[5
]}

Fries, Dietmar ^{[5
]}

Stroehle, Mathias ^{[6
]}

Foidl, Eva ^{[6
]}

Hasibeder, Walter ^{[7
]}

Helbok, Raimund ^{[8
,18
]}

Kirchmair, Lukas ^{[9
]}

Stoegermueller, Birgit ^{[9
]}

Krismer, Christoph ^{[10
]}

Heiner, Tatjana ^{[11
]}

Ladner, Eugen ^{[11
]}

Thome, Claudius ^{[13
]}

Preuss-Hernandez, Christian ^{[13
]}

Mayr, Andreas ^{[12
]}

Potocnik, Miriam ^{[14
]}

Reitter, Bruno ^{[14
]}

Brunner, Juergen ^{[15
,19
]}

Zagitzer-Hofer, Stefanie ^{[16
]}

Ribitsch, Alexandra ^{[17
]}

Joannidis, Michael ^{[1
]}

机构：

[1] Med Univ Innsbruck, Dept Internal Med, Div Intens Care & Emergency Med, Anichstr 35, A-6020 Innsbruck, Austria

[2] Karl Landsteiner Univ Hlth Sci, Internal Med Gastroenterol Hepatol & Rheumatol 2, Univ Hosp St Polten, St Polten, Austria

[3] Med Univ Innsbruck, Dept Anesthesia & Crit Care Med, Innsbruck, Austria

[4] Hosp Hall, Dept Anesthesia & Intens Care Med, Hall In Tirol, Austria

[5] Med Univ Innsbruck, Dept Gen Surg Intens Care Med, Innsbruck, Austria

[6] Hosp Kufstein, Dept Anesthesia & Intens Care Med, Kufstein, Austria

[7] Hosp St Vinzenz Zams, Dept Anesthesiol & Crit Care Med, Zams, Austria

[8] Med Univ Innsbruck, Dept Neurol, Innsbruck, Austria

[9] Hosp Schwaz, Dept Anesthesia & Crit Care Med, Schwaz, Austria

[10] Hosp St Vinzenz Zams, Dept Internal Med, Zams, Austria

[11] Hosp Reutte, Dept Anesthesia & Intens Care Med, Reutte, Austria

[12] Hosp Lienz, Dept Anesthesia & Intens Care Med, Lienz, Austria

[13] Med Univ Innsbruck, Dept Neurosurg, Innsbruck, Austria

[14] Hosp St Johann in Tyrol, Dept Anesthesia & Intens Care Med, St Johann in Tyrol, Austria

[15] Med Univ Innsbruck, Dept Pediat, Innsbruck, Austria

[16] Hosp Hall, Dept Internal Med, Hall In Tirol, Austria

[17] Hosp Lienz, Dept Internal Med, Lienz, Austria

[18] Johannes Kepler Univ Linz, Dept Neurol, Linz, Austria

[19] Danube Private Univ, Fac Med & Dent, Krems, Austria

来源：

JOURNAL OF NEPHROLOGY | 2023年 / 36卷 / 09期

关键词：

SARS-CoV-2; Intensive Care Unit; Renal; Critical care; Pandemic; CORONAVIRUS DISEASE 2019; INTENSIVE-CARE-UNIT; HOSPITALIZED-PATIENTS; CLINICAL CHARACTERISTICS; AKI; MORTALITY; INFECTION; SEPSIS; SAPS-3;

D O I：

10.1007/s40620-023-01760-3

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction:Acute kidney injury is a frequent complication in critically ill patients with and without COVID-19. The aim of this study was to evaluate the incidence of, and risk factors for, acute kidney injury and its effect on clinical outcomes of critically ill COVID-19 patients in Tyrol, Austria. Methods:This multicenter prospective registry study included adult patients with a SARS-CoV-2 infection confirmed by polymerase chain reaction, who were treated in one of the 12 dedicated intensive care units during the COVID-19 pandemic from February 2020 until May 2022. Results:In total, 1042 patients were included during the study period. The median age of the overall cohort was 66 years. Of the included patients, 267 (26%) developed acute kidney injury during their intensive care unit stay. In total, 12.3% (n = 126) required renal replacement therapy with a median duration of 9 (IQR 3-18) days. In patients with acute kidney injury the rate of invasive mechanical ventilation was significantly higher with 85% (n = 227) compared to 41% (n = 312) in the no acute kidney injury group (p < 0.001). The most important risk factors for acute kidney injury were invasive mechanical ventilation (OR = 4.19, p < 0.001), vasopressor use (OR = 3.17, p < 0.001) and chronic kidney disease (OR = 2.30, p < 0.001) in a multivariable logistic regression analysis. Hospital and intensive care unit mortality were significantly higher in patients with acute kidney injury compared to patients without acute kidney injury (Hospital mortality: 52.1% vs. 17.2%, p < 0.001, ICU-mortality: 47.2% vs. 14.7%, p < 0.001). Conclusion:As in non-COVID-19 patients, acute kidney injury is clearly associated with increased mortality in critically ill COVID-19 patients. Among known risk factors, invasive mechanical ventilation has been identified as an independent and strong predictor of acute kidney injury. [GRAPHICS]

引用

页码：2531 / 2540

页数：10