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Acute Kidney Injury in Critically-Ill COVID-19 Patients

Purpose: Acute kidney injury (AKI) is common in patients with COVID-19, however, its mechanism is still controversial, particularly in ICU settings. Urinary proteinuria profile could be a non-invasive tool of interest to scrutinize the pathophysiological process underlying AKI in COVID-19 patients....

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Autores principales: Arrestier, Romain, Gendreau, Ségolène, Mokrani, David, Bastard, Jean-Philippe, Fellahi, Soraya, Bagate, François, Masi, Paul, d’Humières, Thomas, Razazi, Keyvan, Carteaux, Guillaume, De Prost, Nicolas, Audard, Vincent, Mekontso-Dessap, Armand
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999255/
https://www.ncbi.nlm.nih.gov/pubmed/35407639
http://dx.doi.org/10.3390/jcm11072029
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author Arrestier, Romain
Gendreau, Ségolène
Mokrani, David
Bastard, Jean-Philippe
Fellahi, Soraya
Bagate, François
Masi, Paul
d’Humières, Thomas
Razazi, Keyvan
Carteaux, Guillaume
De Prost, Nicolas
Audard, Vincent
Mekontso-Dessap, Armand
author_facet Arrestier, Romain
Gendreau, Ségolène
Mokrani, David
Bastard, Jean-Philippe
Fellahi, Soraya
Bagate, François
Masi, Paul
d’Humières, Thomas
Razazi, Keyvan
Carteaux, Guillaume
De Prost, Nicolas
Audard, Vincent
Mekontso-Dessap, Armand
author_sort Arrestier, Romain
collection PubMed
description Purpose: Acute kidney injury (AKI) is common in patients with COVID-19, however, its mechanism is still controversial, particularly in ICU settings. Urinary proteinuria profile could be a non-invasive tool of interest to scrutinize the pathophysiological process underlying AKI in COVID-19 patients. Material and Methods: We conducted a retrospective study between March 2020 and April 2020. All patients with laboratory-confirmed COVID-19 and without end-stage kidney disease requiring renal replacement therapy before ICU admission were included. Our objectives were to assess the incidence and risk factors for AKI and to describe its clinical and biological characteristics, particularly its urinary protein profile. Results: Seventy patients were included; 87% needed mechanical ventilation and 61% needed vasopressor during their ICU stay; 64.3% of patients developed AKI and half of them needed dialysis. Total and tubular proteinuria on day 1 were higher in patients with AKI, whereas glomerular proteinuria was similar in both groups. The main risk factor for AKI was shock at admission (OR = 5.47 (1.74–17.2), p < 0.01). Mortality on day 28 was higher in AKI (23/45, 51.1%) than in no-AKI patients (1/25, 4%), p < 0.001. Risk factors for 28-days mortality were AKI with need for renal replacement therapy, non-renal SOFA score and history of congestive heart failure. Conclusions: AKI is common in COVID-19 patients hospitalized in ICU; it seems to be related to tubular lesions rather than glomerular injury and is related to shock at ICU admission.
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spelling pubmed-89992552022-04-12 Acute Kidney Injury in Critically-Ill COVID-19 Patients Arrestier, Romain Gendreau, Ségolène Mokrani, David Bastard, Jean-Philippe Fellahi, Soraya Bagate, François Masi, Paul d’Humières, Thomas Razazi, Keyvan Carteaux, Guillaume De Prost, Nicolas Audard, Vincent Mekontso-Dessap, Armand J Clin Med Article Purpose: Acute kidney injury (AKI) is common in patients with COVID-19, however, its mechanism is still controversial, particularly in ICU settings. Urinary proteinuria profile could be a non-invasive tool of interest to scrutinize the pathophysiological process underlying AKI in COVID-19 patients. Material and Methods: We conducted a retrospective study between March 2020 and April 2020. All patients with laboratory-confirmed COVID-19 and without end-stage kidney disease requiring renal replacement therapy before ICU admission were included. Our objectives were to assess the incidence and risk factors for AKI and to describe its clinical and biological characteristics, particularly its urinary protein profile. Results: Seventy patients were included; 87% needed mechanical ventilation and 61% needed vasopressor during their ICU stay; 64.3% of patients developed AKI and half of them needed dialysis. Total and tubular proteinuria on day 1 were higher in patients with AKI, whereas glomerular proteinuria was similar in both groups. The main risk factor for AKI was shock at admission (OR = 5.47 (1.74–17.2), p < 0.01). Mortality on day 28 was higher in AKI (23/45, 51.1%) than in no-AKI patients (1/25, 4%), p < 0.001. Risk factors for 28-days mortality were AKI with need for renal replacement therapy, non-renal SOFA score and history of congestive heart failure. Conclusions: AKI is common in COVID-19 patients hospitalized in ICU; it seems to be related to tubular lesions rather than glomerular injury and is related to shock at ICU admission. MDPI 2022-04-05 /pmc/articles/PMC8999255/ /pubmed/35407639 http://dx.doi.org/10.3390/jcm11072029 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Arrestier, Romain
Gendreau, Ségolène
Mokrani, David
Bastard, Jean-Philippe
Fellahi, Soraya
Bagate, François
Masi, Paul
d’Humières, Thomas
Razazi, Keyvan
Carteaux, Guillaume
De Prost, Nicolas
Audard, Vincent
Mekontso-Dessap, Armand
Acute Kidney Injury in Critically-Ill COVID-19 Patients
title Acute Kidney Injury in Critically-Ill COVID-19 Patients
title_full Acute Kidney Injury in Critically-Ill COVID-19 Patients
title_fullStr Acute Kidney Injury in Critically-Ill COVID-19 Patients
title_full_unstemmed Acute Kidney Injury in Critically-Ill COVID-19 Patients
title_short Acute Kidney Injury in Critically-Ill COVID-19 Patients
title_sort acute kidney injury in critically-ill covid-19 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999255/
https://www.ncbi.nlm.nih.gov/pubmed/35407639
http://dx.doi.org/10.3390/jcm11072029
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