Survival and renal recovery after continuous renal replacement therapy in critically ill COVID-19 patients

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Created On: 05/07/2021

Survival and renal recovery after continuous renal replacement therapy in critically ill COVID-19 patients

This observational study was carried to explore the characteristics and outcomes in adult COVID-19 patients receiving CRRT.

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Key take away

Using continuous renal replacement therapy (CRRT) in COVID-19 patients having acute kidney injury (AKI) leads to 90-day mortality in 45.1% of patients. Approximately three-quarters of the surviving patients witnessed improvement in kidney function at the follow-up.

Background

This observational study was carried to explore the characteristics and outcomes in adult COVID-19 patients receiving CRRT.

Method

The study incorporated a cohort of critically ill COVID-19 patients with AKI that were admitted to the intensive care unit (ICU). The participants were treated with CRRT. The major endpoint was 60-day mortality while the secondary outcomes in CRRT patients were alteration in body weight during ICU stay, 90-day mortality, intermittent hemodialysis dependence at hospital discharge, renal recovery, and estimated glomerular filtration rate at the follow-up.

Result

The occurrence of AKI was reported in 451 COVID patients. About 18.2% of patients (median age 60 years, 90% male, median BMI 29) received CRRT. Notably, 23.2% of patients were diabetic, 37.8% had high blood pressure and 6.1% had chronic kidney disease before the ICU admission.

All the patients needed mechanical ventilation. The patients stayed in ICU for 23 days on an average. ICU mortality was 39% and about 45.1% of patients succumbed to death in 90 days. The 60 days mortality was linked with age, baseline creatinine values, and change in body weight.

The mortality in the CRRT group was considerably greater than non-CRRT patients, as shown below:

Out of those who survived, none needed dialysis at discharge from the hospital or follow-up and 73.8% had improved renal function. The CRRT coronavirus survivors witnessed a median 10.5% decline in body weight during the hospital stay.

Conclusion

Critically ill coronavirus-infected people with AKI who received CRRT had a 90-day mortality of 45.1%. About three-quarters of survivors had recovered kidney function at the follow-up. The study provided notable insights concerning the clinical management of COVID-19.