Acute kidney injury in the Intensive Care Unit patients with coronavirus disease 2019: a single-center study

Background and objective : Early reports suggest that acute kidney injury (AKI) is common in patients with coronavirus disease 2019 (COVID-19) and is associated with poorer outcomes. However, AKI in COVID-19 patients with in the intensive care units (ICUs) remains poorly characterized. Methods This retrospective observational study reviewed electronic health record data from patients with laboratory-confirmed COVID-19 who were admitted to the Critical Care Medicine, Zhongshan People’s Hospital between May 01,2020 and December 31, 2023. Patients were classified into AKI and non-AKI groups according to the KDIGO criteria for AKI diagnosis. Differences between the two groups were compared, and logistic regression was used to analyze the association between AKI and mortality. Results A total of 142 COVID-19 patients were included in the study, of whom 114 (80.3%) were male, with a median age of 75 years. Among them, 16 patients (11.3%) had moderate to severe infection, and 125 patients (88.0%) had severe infection. AKI occurred in 74 (52.1%) patients. The proportions with stages 1, 2, or 3 AKI were 12.3%, 16.2%, and 22.5%, respectively. There were 80 deaths (56.3%) among the patients. After adjusting for confounding factors such as age, gender, comorbidities, white blood cell count, red blood cell count, hemoglobin level, platelet count, baseline serum creatinine, antiviral treatment, corticosteroid use, mechanical ventilation and Extracorporeal Membrane Oxygenation and Continuous Venovenous Hemofiltration(CVVH), AKI remained an independent risk factor for all-cause mortality (OR = 3.93, 95% CI: 1.15–13.45). Conclusion The incidence of AKI is high among COVID-19 patients admitted to the ICU and is associated with in-hospital mortality. Therefore, clinicians should remain vigilant in managing critically ill COVID-19 patients, with particular attention to the risk of AKI.