The Complications of Acute Kidney Injury in Critically Ill COVID-19 Patients

Abstract

Background: Various manifestations of COVID-19, and the occurrence of Acute Kidney Injury (AKI) in critically ill patients have been associated with higher mortality rates. This study aimed to find the outcome and complications of Acute Kidney Injury in critically ill COVID-19 Patients.

Method: This single-center study is based on the Kidney Disease Improving Global Outcomes (KDIGO) renal staging to ascertain the frequency and outcomes of patients(n=200) in the intensive care unit (ICU) with AKI and COVID-19 in the initial pandemic in Karachi. Study conducted between April 2020 – July 2021, in the ICU with critical COVID-19 patients at Ziauddin Hospital Clifton, Karachi. The variables employed to assess severity and outcomes were ventilation organ support, use of vasoactive therapy, need for renal replacement therapy (RRT), and patient status at ICU and/or hospital discharge.

Results: Two hundred patients were enrolled in the study, most were males (70%) with a mean age of 65 + 13 years. The frequency of AKI as per KDIGO stages was 43.5%, 13.5%, and 43% for AKI stages 1, 2, and 3, respectively. Forty-six patients (23%) required RRT. Among 200 patients, 75 % were known hypertensive and 45% were diabetics. Our results demonstrated that the overall mortality was 58.5% of patients, while the mortality rate of those who received RRT was 78.3%.

Conclusion: COVID-19 with AKI in critically ill patients was associated with worsened disease processes and a higher mortality rate. Most patients were elderly, hypertensive, and diabetics. The mortality rates were higher with higher stages of AKI and those needing RRT.