Characterization of hospitalized patients with acute kidney injury associated with COVID-19 in Spain: renal replacement therapy and mortality. FRA-COVID SEN Registry Data

• Published in: Nefrología 2024-07, Vol.44 (4), p.527-539
• Main Authors: Salgueira, M., Almenara, M., Gutierrez-Pizarraya, A., Belmar, L., Labrador, P.J., Melero, R., Serrano, M., Portolés, J.M., Molina, A., Poch, E., Ramos, N., Lloret, M.J., Echarri, R., Díaz-Mancebo, R., González- Lara, D.M., Sánchez, J.E., Soler, M.J.
• Format: Article
• Language: English
• Subjects: Acute kidney injury; Acute Kidney Injury - etiology; Acute Kidney Injury - mortality; Acute Kidney Injury - therapy; Aged; Betacoronavirus; Comorbidity; Coronavirus Infections - complications; Coronavirus Infections - mortality; Coronavirus Infections - therapy; COVID-19; COVID-19 - complications; COVID-19 - mortality; COVID-19 - therapy; Daño renal agudo; Female; Hemodialysis; Hemodiálisis; Hospital Mortality; Hospitalization - statistics & numerical data; Humans; Male; Middle Aged; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - mortality; Pneumonia, Viral - therapy; Registries; Renal replacement therapy; Renal Replacement Therapy - statistics & numerical data; Respiration, Artificial - statistics & numerical data; Retrospective Studies; SARS-CoV-2; Spain - epidemiology; Tratamiento renal sustitutivo
• ISSN: 2013-2514; 2013-2514
• DOI: 10.1016/j.nefroe.2023.03.017

Acute kidney injury (AKI) is common among hospitalized patients with COVID-19 and associated with worse prognosis. The Spanish Society of Nephrology created the AKI- COVID Registry to characterize the population admitted for COVID-19 that developed AKI in Spanish hospitals. The need of renal replacement therapy (RRT) therapeutic modalities, and mortality in these patients were assessed In a retrospective study, we analyzed data from the AKI-COVID Registry, which included patients hospitalized in 30 Spanish hospitals from May 2020 to November 2021. Clinical and demographic variables, factors related to the severity of COVID-19 and AKI, and survival data were recorded. A multivariate regression analysis was performed to study factors related to RRT and mortality. Data from 730 patients were recorded. A total of 71.9% were men, with a mean age of 70 years (60–78), 70.1% were hypertensive, 32.9% diabetic, 33.3% with cardiovascular disease and 23.9% had some degree of chronic kidney disease (CKD). Pneumonia was diagnosed in 94.6%, requiring ventilatory support in 54.2% and admission to the ICU in 44.1% of cases. The median time from the onset of COVID-19 symptoms to the appearance of AKI (37.1% KDIGO I, 18.3% KDIGO II, 44.6% KDIGO III) was 6 days (4–10). A total of 235 (33.9%) patients required RRT: 155 patients with continuous renal replacement therapy, 89 alternate-day dialysis, 36 daily dialysis, 24 extended hemodialysis and 17 patients with hemodiafiltration. Smoking habit (OR 3.41), ventilatory support (OR 20.2), maximum creatinine value (OR 2.41), and time to AKI onset (OR 1.13) were predictors of the need for RRT; age was a protective factor (0.95). The group without RRT was characterized by older age, less severe AKI, and shorter kidney injury onset and recovery time (p