[Characterization of hospitalized patients with acute kidney injury associated with COVID-19 in Spain: Renal replacement therapy and mortality. FRA-COVID SEN Registry Data].

التفاصيل البيبلوغرافية
العنوان:	[Characterization of hospitalized patients with acute kidney injury associated with COVID-19 in Spain: Renal replacement therapy and mortality. FRA-COVID SEN Registry Data].
عنوان ترانسليتريتد:	Caracterización de la población con fracaso renal agudo durante la hospitalización por COVID-19 en España: tratamiento renal sustitutivo y mortalidad. Datos del Registro FRA-COVID SEN.
المؤلفون:	Salgueira M; Unidad de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, España., Almenara M; Unidad de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, España., Gutierrez-Pizarraya A; Unidad de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, España., Belmar L; Unidad de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España., Labrador PJ; Unidad de Nefrología, Complejo Hospitalario Universitario de Cáceres, Cáceres, España., Melero R; Unidad de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España., Serrano ML; Unidad de Nefrología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España., Portolés JM; Unidad de Nefrología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España., Molina A; Unidad de Nefrología, Hospital Clinic, Barcelona, España., Poch E; Unidad de Nefrología, Hospital Clinic, Barcelona, España., Ramos N; Unidad de Nefrología, Hospital Vall d'Hebron, Barcelona, España., Lloret MJ; Unidad de Nefrología, Fundació Puigvert, Barcelona, España., Echarri R; Unidad de Nefrología, Hospital Universitario Infanta Sofía, Madrid, España., Díaz Mancebo R; Unidad de Nefrología, Hospital Universitario Infanta Sofía, Madrid, España., González-Lara DM; Unidad de Nefrología, Complejo Hospitalario Universitario de Toledo, Toledo, España., Sánchez JE; Unidad de Nefrología, Hospital Universitario de Cabueñes, Gijón, España., Soler MJ; Unidad de Nefrología, Hospital Vall d'Hebron, Barcelona, España.
المصدر:	Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia [Nefrologia] 2023 Apr 06. Date of Electronic Publication: 2023 Apr 06.
Publication Model:	Ahead of Print
نوع المنشور:	English Abstract; Journal Article
اللغة:	Spanish; Castilian
بيانات الدورية:	Publisher: Elsevier Country of Publication: Spain NLM ID: 8301215 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1989-2284 (Electronic) Linking ISSN: 02116995 NLM ISO Abbreviation: Nefrologia
أسماء مطبوعة:	Publication: Vol. 35, no. 2 2015- : Barcelona : Elsevier Original Publication: Madrid : Sociedad Española De Nefrologia
مستخلص:	Background and Objectives: Acute kidney injury (AKI) is common among hospitalized patients with COVID-19 and associated with worse prognosis. The Spanish Society of Nephrology created the AKI-COVID Registry to characterize the population admitted for COVID-19 that developed AKI in Spanish hospitals. The need of renal replacement therapy (RRT) therapeutic modalities, and mortality in these patients were assessed. Material and Method: In a retrospective study, we analyzed data from the AKI-COVID Registry, which included patients hospitalized in 30 Spanish hospitals from May 2020 to November 2021. Clinical and demographic variables, factors related to the severity of COVID-19 and AKI, and survival data were recorded. A multivariate regression analysis was performed to study factors related to RRT and mortality. Results: Data from 730 patients were recorded. A total of 71.9% were men, with a mean age of 70 years (60-78), 70.1% were hypertensive, 32.9% diabetic, 33.3% with cardiovascular disease and 23.9% had some degree of chronic kidney disease (CKD). Pneumonia was diagnosed in 94.6%, requiring ventilatory support in 54.2% and admission to the ICU in 44.1% of cases.The median time from the onset of COVID-19 symptoms to the appearance of AKI (37.1% KDIGO I, 18.3% KDIGO II, 44.6% KDIGO III) was 6 days (4-10). A total of 235 (33.9%) patients required RRT: 155 patients with continuous renal replacement therapy, 89 alternate-day dialysis, 36 daily dialysis, 24 extended hemodialysis and 17 patients with hemodiafiltration. Smoking habit (OR 3.41), ventilatory support (OR 20.2), maximum creatinine value (OR 2.41) and time to AKI onset (OR 1.13) were predictors of the need for RRT; age was a protective factor (0.95). The group without RRT was characterized by older age, less severe AKI, shorter kidney injury onset and recovery time ( p < 0.05). 38.6% of patients died during hospitalization; serious AKI and RRT were more frequent in the death group. In the multivariate analysis, age (OR 1.03), previous chronic kidney disease (OR 2.21), development of pneumonia (OR 2.89), ventilatory support (OR 3.34) and RRT (OR 2.28) were predictors of mortality while chronic treatment with ARBs was identified as a protective factor (OR 0.55). Conclusions: Patients with AKI during hospitalization for COVID-19 had a high mean age, comorbidities and severe infection. We defined two different clinical patterns: an AKI of early onset, in older patients that resolves in a few days without the need for RRT; and another more severe pattern, with greater need for RRT, and late onset, which was related to greater severity of the infectious disease. The severity of the infection, age and the presence of CKD prior to admission were identified as risk factors for mortality in these patients. In addition chronic treatment with ARBs was identified as a protective factor for mortality. (© 2023 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U.)
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فهرسة مساهمة:	Keywords: Acute kidney injury; COVID-19; Hemodialysis; Renal replacement therapy; SARS-CoV-2
تواريخ الأحداث:	Date Created: 20230626 Latest Revision: 20230701
رمز التحديث:	20240628
مُعرف محوري في PubMed:	PMC10076078
DOI:	10.1016/j.nefro.2023.03.008
PMID:	37359780
قاعدة البيانات:	MEDLINE

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تدمد:	1989-2284
DOI:	10.1016/j.nefro.2023.03.008