Copy For Citation
ÇINAR Z., Altıntaş S., ÖZDEMİR U., GÜRSOY G.
16TH WORLD INTENSIVE AND CRITICAL CARE CONGRESS, İstanbul, Turkey, 26 - 30 August 2023, vol.81
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Publication Type:
Conference Paper / Summary Text
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Volume:
81
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Doi Number:
10.1016/j.jcrc.2024.154728
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City:
İstanbul
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Country:
Turkey
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Ankara University Affiliated:
Yes
Abstract
Introduction and aim
Respiratory system is the main target for COVID-19, other systems may also be affected. Acute kidney injury (AKI) is a sudden and usually reversible decrease in glomerular filtration rate. The rate of AKI development in critically ill patients is 30–60%, and it affects mortality and morbidity. We aimed to examine AKI development rate, risk factors and their effects on intensive care outcomes in critical COVID-19 patients who are without end-stage renal disease.
Patients and methods
A total of 97 patients followed up in the COVID-19 Intensive Care Unit (ICU) of Ankara Training and Research Hospital, between 01.01.2021 and 01.03.2022 were included in our study. Demographic data, comorbidities, critical illness severity scores, laboratory parameters, type of respiratory supports and medical treatments were recorded retrospectively The relationship of all these parameters with the development of AKI were investigated. AKI was determined based on the Risk, Injury, Failure, Loss of Kidney Function, End Stage Kidney Disease (RIFLE) classification. All data were evaluated using the SPSS 25.0 programme.
Results
A total of 97 patients, 53.6% female (n = 52) was included in our study. While AKI was present in 25 (n = 97,25.8%) patients at the time of admission to the ICU, AKI developed in 38 (n = 72, 52,8%) patients during ICU follow-up. The mean age of the patients who developed AKI was 74.7 ± 10.7 (p:0.004). No significant effect of comorbidities which cause end-organ damage such as hypertension on the development of AKI was detected (p > 0.05). Favipravir, methylprednisolone, anakinra, which are frequently used in Covid-19 treatments, were not found to be significantly associated with AKI(p›0.05). AKI occurred on average 2[0–7] days after admission to the ICU, renal replacement therapy(RRT)was applied in 15.5% of these patients. High critical illness score(p:0,0001), invasive mechanical ventilation (IMV)(p:0,0001) and RRT (p.0,001), presence of sepsis/septic shock(p:0,0001) were determined as factors increasing mortality. Advanced age (OR:1094 95% CI[1.012–1.183, p:0.024]) and presence of sepsis/septic shock (OR:11,74 95% CI[2.206–68.058, p:0.006]) were determined as independent risk factors for the development of AKI.
Conclusion
High critical illness severity scores, advanced age, presence of sepsis/septic shock and IMV applications cause a significant increase in the development of AKI and mortality in ICU. Comorbidities do not pose a risk for newly developing AKI, if they are controlled by medical treatment. With the management of sepsis/septic shock with current guidelines; recognizing AKI in the early period and providing the necessary treatments will contribute significantly to reducing mortality.