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  1. Article: Incidence and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019.

    Abdallah, Emad / Al Helal, Bassam / Asad, Reem / Hemida, Mohamed / Nawar, Ehab / Kamal, Mohammad / Reda, Mahmoud / Baharia, Ahmed / Galal, Ahmed / Hassan, Ali / Awaga, Ahmed / Salam, Mostafa / Shama, Abdelfatah

    Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

    2021  Volume 32, Issue 1, Page(s) 84–91

    Abstract: ... for developing acute kidney injury (AKI). The aim of our study was to analyze incidence and outcomes of AKI ... hemodynamic support and avoidance of nephrotoxic drugs, may help to improve critically ill patients with COVID ... dialysis dependent. Incidence of AKI is high in ICU COVID-19 patients and is associated with poor outcomes ...

    Abstract Patients with more severe cases of coronavirus disease-19 (COVID-19) may be at greater risk for developing acute kidney injury (AKI). The aim of our study was to analyze incidence and outcomes of AKI in critically ill patients with COVID-19. Our study prospectively followed about 198 patients with COVID-19 admitted to intensive care unit (ICU), Al Adan Hospital, Kuwait, for developing AKI and outcomes. Age, gender, nationality, history of hypertension, diabetes mellitus, ischemic heart disease, congestive heart failure, bronchial asthma, and chronic obstructive pulmonary disease were analyzed. The need for mechanical ventilation (MV), extracorporeal membrane oxygenation, inotropes, and medications was recorded. Causes of AKI, indication of dialysis, dialysis modality, dialysis outcomes, and mortality were analyzed. Our study reported that61 out of 198 (30.8%) ICU patients positive for COVID-19, developed AKI according to the Kidney Disease Improving Global Outcomes definition of AKI. Forty-eight out of 61 (79%) patients need continuous renal replacement therapy using continuous venovenous hemodiafiltration. Thirty-seven (61%) out of 61 patients were with severe sepsis syndrome. The most common cause of AKI was sepsis, cytokine storm, hypovolemia, heart failure, MV, and nephrotoxic drugs. Twenty-four patients (39%) out of 61 patients died, and the most common cause of death was sepsis, cytokine storm with respiratory failure, heart failure, and AKI. The outcome of AKI was as follows: six patients (10%) had complete recovery, five patients had partial recovery (8%), and 26 (43%) patients became dialysis dependent. Incidence of AKI is high in ICU COVID-19 patients and is associated with poor outcomes and high mortality. Early detection and specific therapy of kidney changes, including adequate hemodynamic support and avoidance of nephrotoxic drugs, may help to improve critically ill patients with COVID-19.
    MeSH term(s) Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/mortality ; Acute Kidney Injury/therapy ; Adult ; COVID-19/epidemiology ; COVID-19/therapy ; Critical Care ; Critical Illness ; Female ; Humans ; Incidence ; Kuwait/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; SARS-CoV-2 ; Sepsis/complications ; Survival Rate ; Treatment Outcome
    Language English
    Publishing date 2021-06-17
    Publishing country Saudi Arabia
    Document type Journal Article
    ZDB-ID 1379955-1
    ISSN 1319-2442
    ISSN 1319-2442
    DOI 10.4103/1319-2442.318551
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Incidence and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019

    Emad Abdallah / Bassam Al Helal / Reem Asad / Mohamed Hemida / Ehab Nawar / Mohammad Kamal / Mahmoud Reda / Ahmed Baharia / Ahmed Galal / Ali Hassan / Ahmed Awaga / Mostafa Salam / Abdelfatah Shama

    Saudi Journal of Kidney Diseases and Transplantation, Vol 32, Iss 1, Pp 84-

    2021  Volume 91

    Abstract: ... for developing acute kidney injury (AKI). The aim of our study was to analyze incidence and outcomes of AKI ... hemodynamic support and avoidance of nephrotoxic drugs, may help to improve critically ill patients with COVID ... dialysis dependent. Incidence of AKI is high in ICU COVID-19 patients and is associated with poor outcomes ...

    Abstract Patients with more severe cases of coronavirus disease-19 (COVID-19) may be at greater risk for developing acute kidney injury (AKI). The aim of our study was to analyze incidence and outcomes of AKI in critically ill patients with COVID-19. Our study prospectively followed about 198 patients with COVID-19 admitted to intensive care unit (ICU), Al Adan Hospital, Kuwait, for developing AKI and outcomes. Age, gender, nationality, history of hypertension, diabetes mellitus, ischemic heart disease, congestive heart failure, bronchial asthma, and chronic obstructive pulmonary disease were analyzed. The need for mechanical ventilation (MV), extracorporeal membrane oxygenation, inotropes, and medications was recorded. Causes of AKI, indication of dialysis, dialysis modality, dialysis outcomes, and mortality were analyzed. Our study reported that61 out of 198 (30.8%) ICU patients positive for COVID-19, developed AKI according to the Kidney Disease Improving Global Outcomes definition of AKI. Forty-eight out of 61 (79%) patients need continuous renal replacement therapy using continuous venovenous hemodiafiltration. Thirty-seven (61%) out of 61 patients were with severe sepsis syndrome. The most common cause of AKI was sepsis, cytokine storm, hypovolemia, heart failure, MV, and nephrotoxic drugs. Twenty-four patients (39%) out of 61 patients died, and the most common cause of death was sepsis, cytokine storm with respiratory failure, heart failure, and AKI. The outcome of AKI was as follows: six patients (10%) had complete recovery, five patients had partial recovery (8%), and 26 (43%) patients became dialysis dependent. Incidence of AKI is high in ICU COVID-19 patients and is associated with poor outcomes and high mortality. Early detection and specific therapy of kidney changes, including adequate hemodynamic support and avoidance of nephrotoxic drugs, may help to improve critically ill patients with COVID-19.
    Keywords Medicine ; R
    Subject code 610 ; 616
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: The Incidence of Acute Kidney Injury (AKI) in Critically Ill COVID-19 Patients: A Single-Center Retrospective Cohort Study at a Tertiary Level Hospital in Oman.

    Al Abri, Sulaiman Y / Burad, Jyoti / Al Wahaibi, Mazin M

    Cureus

    2023  Volume 15, Issue 6, Page(s) e40340

    Abstract: ... patients. Coronavirus disease 2019 (COVID-19) affects the renal system frequently and leads to AKI ... Background:  Acute kidney injury (AKI) is associated with adverse outcomes in critically ill ... incidence of AKI for critically ill COVID-19 cases was found in this study. The shock was the only ...

    Abstract Background:  Acute kidney injury (AKI) is associated with adverse outcomes in critically ill patients. Coronavirus disease 2019 (COVID-19) affects the renal system frequently and leads to AKI. This study aims to determine the incidence of AKI, risk factors including hyperglycemia, and the requirement for renal dialysis.
    Methods:  A retrospectively observational study was done at Sultan Qaboos University Hospital between March 2020 and September 2021. A total of 286 adult patients with laboratory-confirmed COVID-19 infection admitted to the intensive care unit (ICU) were included in the study. The patient's medical records were reviewed. Patients' baseline demographic characteristics, APACHE score on admission, clinical data including length of stay, oxygenation parameters, ventilator days, shock, AKI (KIDIGO guideline), dialysis, medications, lab on admission as well as during the ICU stay, and the outcome (mortality) were recorded in detail. Follow-up was done till discharge from ICU.
    Results:  The study population included 68.5% (196/286) males. The median age was 56 years (interquartile range, IQR: 43-66.25). The incidence of AKI was 55.2% (158/286) overall. Out of those who had AKI, 27.2% (43/158), 31.6% (50/158), and 41.1% (65/158) developed AKI stages 1, 2, and 3, respectively. Univariate analysis for the development of AKI showed the following significant variables: age (p=0.005; odds ratio, OR 1.024; 95% confidence interval, CI 1.007-1.041), creatinine level on admission (p=0.012; OR 1.005; 95%CI 1.001-1.008), APACHE score on admission (p<0.001; OR 1.049; 95%CI 1.021-1.077), P/F ratio (p<0.001; OR 0.991; 95%CI 0.987-0.995), nephrotoxic agent (p<0.001; OR 8.556; 95%CI 4.733-15.467), shock (p<0.001; OR 8.690; 95%CI 5.087-14.843), days on the ventilator (p<0.001; OR 1.085; 95%CI 1.043-1.129), and length of stay in ICU (p<0.001; OR 1.082; 95%CI 1.047-1.119). The multivariate analysis confirmed only shock (p=0.004; OR 5.893; 95%CI 1.766-19.664). A total of 41.7% (66/158) of patients received dialysis. Hyperglycemia was not associated with the development of AKI. For patients with AKI, those having high APACHE score (p<0.001), shock (p=0.56; OR 2.326; 95%CI 1.036-5.223), ischemic heart disease (IHD) (p=0.002; OR 9.000; 95%CI 1.923-42.130), and hypertension (p=0.023; OR 2.145; 95%CI 11.125-4.090) were significantly associated with the requirement of dialysis. The mortality was found to be 59.1% (169/286) overall whereas it was 83.5% (132/158) for AKI versus 28.9% (37/158) for non-AKI cases.
    Conclusions:  A high incidence of AKI for critically ill COVID-19 cases was found in this study. The shock was the only significant predictor for the development of AKI. AKI is associated with high mortality in these patients.
    Language English
    Publishing date 2023-06-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.40340
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Decreasing Incidence of Acute Kidney Injury in Patients with COVID-19 Critical Illness in New York City.

    Charytan, David M / Parnia, Sam / Khatri, Minesh / Petrilli, Christopher M / Jones, Simon / Benstein, Judith / Horwitz, Leora I

    Kidney international reports

    2021  Volume 6, Issue 4, Page(s) 916–927

    Abstract: ... complicates coronavirus disease 2019 (COVID-19), but understanding of AKI risks and outcomes is incomplete ... of kidney function. Logistic regression was used to assess associations of patient characteristics and ... Introduction: Reports from the United States suggest that acute kidney injury (AKI) frequently ...

    Abstract Introduction: Reports from the United States suggest that acute kidney injury (AKI) frequently complicates coronavirus disease 2019 (COVID-19), but understanding of AKI risks and outcomes is incomplete. In addition, whether kidney outcomes have evolved during the course of the pandemic is unknown.
    Methods: We used electronic medical records to identify patients with COVID-19 with and without AKI admitted to 3 New York Hospitals between March 2 and August 25, 2020. Outcomes included AKI overall and according to admission week, AKI stage, the requirement for new renal replacement therapy (RRT), mortality, and recovery of kidney function. Logistic regression was used to assess associations of patient characteristics and outcomes.
    Results: Of 4732 admissions, 1386 (29.3%) patients had AKI. Among those with AKI, 717 (51.7%) had stage 1 disease, 132 (9.5%) had stage 2 disease, 537 (38.7%) had stage 3 disease, and 237 (17.1%) required RRT initiation. In March, 536 of 1648 (32.5%) patients developed AKI compared with 15 of 87 (17.2%) in August (
    Conclusions: AKI impacts a high proportion of admitted patients with COVID-19 and is associated with high mortality, particularly when RRT is required. AKI incidence appears to be decreasing over time and kidney function frequently recovers in those who survive.
    Language English
    Publishing date 2021-02-04
    Publishing country United States
    Document type Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2021.01.036
    Database MEDical Literature Analysis and Retrieval System OnLINE

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