Acute kidney injury in critically ill patients with COVID-19: prevalence, risk factors and mortality in eastern Morocco.

Abstract

IntroductionAcute kidney injury (AKI) is commonly seen in critically ill hospitalized patients with COVID-19 and its incidence reaches 60% in this setting. The aim of this work was to determine the prevalence, characteristics, risk factors and mortality of AKI in patients admitted to the intensive care unit (ICU) for COVID-19.Patients and methodsThis observational retrospective case series was conducted between February 1, 2020 and December 31, 2020 at the ICU of the university hospital Mohammed VI of Oujda, Morocco. all COVID-19 patients hospitalized in the ICU with acute respiratory failure were included. AKI was defined and classified into three stages using the KDIGO criteria 2012. We excluded patients with end-stage kidney disease and those who were under 18 years old.ResultsSix hundred adult patients were included and 65.5% of them were men. Sixty patients had minimal lung damage (< 25%), 105 patients had mild lung damage (25–50%), 186 had severe lung damage (50–75%) and 193 patients had very severe lung damage (> 75%). A total of 210 patients (35%) developed AKI, of whom 78 (37.2%) had mild AKI (stage 1) and 132 (62.8%) severe AKI (stages 2 and 3). Patients in the severe and mild AKI groups had a higher rate of comorbidities, especially hypertension (mild AKI [46.2%] vs. severe AKI [36.4%] vs. no AKI [27.4%], p = 0.002) and diabetes (mild AKI [52.6%] vs. severe AKI [33.3%] vs. no AKI [26.4%], p < 0.001). During hospitalization, 23.3% of patients with AKI received kidney replacement therapy. In-hospital mortality was observed in 51.3% for mild AKI, 55.3% for severe AKI and 21% in patients who did not have AKI (p < 0.001).ConclusionOur findings revealed that not only severe AKI, but also mild AKI was correlated to in-hospital mortality. Whatever the severity of the kidney impairment, it remains a major prognostic element.