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Acute kidney injury in critically ill COVID-19 infected patients requiring dialysis : experience from India and Pakistan
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Anandh, Urmila, Noorin, Amna, Kazmi, Syed Khurram Shehzad, Bannur, Sooraj, Shah, Syed Shahkar Ahmed, Farooq, Mehrin, Yedlapati, Gopikrishna, Amer, Waseem, Prasad, Bonthu and Dasgupta, Indranil (2022) Acute kidney injury in critically ill COVID-19 infected patients requiring dialysis : experience from India and Pakistan. BMC Nephrology, 23 (1). 308. doi:10.1186/s12882-022-02931-3 ISSN 1471-2369.
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Official URL: https://doi.org/10.1186/s12882-022-02931-3
Abstract
Background: Acute kidney injury (AKI) was common in the first two waves of the SARS-COV-2 pandemic in critically ill patients. A high percentage of these patients required renal replacement therapy and died in the hospital. Methods: The present study examines the clinical presentation, laboratory parameters and therapeutic interventions in critically ill patients with AKI admitted to the ICU in two centres, one each in India and Pakistan. Patient and outcome details of all critically ill COVID 19 patients admitted to the ICU requiring renal replacement therapy were collected. Data was analysed to detect patient variables associated with mortality. Results: A total of 1,714 critically ill patients were admitted to the ICUs of the two centres. Of these 393 (22.9%) had severe acute kidney injury (AKIN stage 3) requiring dialysis. Of them, 60.5% were men and the mean (± SD) age was 58.78 (± 14.4) years. At the time of initiation of dialysis, 346 patients (88%) were oligo-anuric. The most frequent dialysis modality in these patients was intermittent hemodialysis (48.1%) followed by slow low efficiency dialysis (44.5%). Two hundred and six (52.4%) patients died. The mortality was higher among the Indian cohort (68.1%) than the Pakistani cohort (43.4%). Older age (age > 50 years), low serum albumin altered sensorium, need for slower forms of renal replacement therapy and ventilatory support were independently associated with mortality. Conclusion: There was a very high mortality in patients with COVID-19 associated AKI undergoing RRT in the ICUs in this cohort from the Indian sub-continent.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||
| Library of Congress Subject Headings (LCSH): | Acute renal failure -- Treatment , Renal intensive care, COVID-19 (Disease) -- India, Mortality -- India, Mortality -- Pakistan, COVID-19 (Disease) -- Pakistan, Hemodialysis | ||||||
| Journal or Publication Title: | BMC Nephrology | ||||||
| Publisher: | BioMed Central Ltd. | ||||||
| ISSN: | 1471-2369 | ||||||
| Official Date: | 8 September 2022 | ||||||
| Dates: |
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| Volume: | 23 | ||||||
| Number: | 1 | ||||||
| Article Number: | 308 | ||||||
| DOI: | 10.1186/s12882-022-02931-3 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 20 October 2022 | ||||||
| Date of first compliant Open Access: | 21 October 2022 |
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