Outcomes of renal replacement therapy in the critically ill with COVID-19.

Abstract

ObjectiveTo describe outcomes of critically ill patients with COVID-19, particularly the association of renal replacement therapy to mortality.DesignA single-center prospective observational study was carried out.SettingICU of a tertiary care center.PatientsConsecutive adults with COVID-19 admitted to the ICU.InterventionRenal replacement therapy.Main variables of interestDemographic data, medical history, illness severity, type of oxygen therapy, laboratory data and use of renal replacement therapy to generate a logistic regression model describing independent risk factors for mortality.ResultsOf the total of 166 patients, 51% were mechanically ventilated and 26% required renal replacement therapy. The overall hospital mortality rate was 36%, versus 56% for those requiring renal replacement therapy, and 68% for those with both mechanical ventilation and renal replacement therapy. The logistic regression model identified four independent risk factors for mortality: age (adjusted OR 2.8 [95% CI 1.8–4.4] for every 10-year increase), mechanical ventilation (4.2 [1.7–10.6]), need for continuous venovenous hemofiltration (2.3 [1.3–4.0]) and C-reactive protein (1.1 [1.0–1.2] for every 10 mg/L increase).ConclusionsIn our cohort, acute kidney injury requiring renal replacement therapy was associated to a high mortality rate similar to that associated to the need for mechanical ventilation, while multiorgan failure necessitating both techniques implied an extremely high mortality risk.