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• W4212907029 abstract "Acute kidney injury (AKI) is a common complication in patients infected with SARS COV-2. The incidence rates are very high (76%) in patients admitted in the intensive care unit. A high percentage of critically ill patients have severe acute kidney injury and require renal replacement therapy (RRT) with consequent high mortality. The prospective study looks into the clinical presentation, laboratory parameters and therapeutic interventions in critically sick patients with AKI requiring RRT admitted in the intensive care unit of our hospital from April 2020 to December 2020. The demographic details, laboratory parameters , therapeutic interventions and outcome details were collected. Data was analyzed to detect significant patient variables which had an association with mortality. Initial chi- square test was performed to look at significant association. All significant variables were then included in a multivariate analysis. All statistical analyses were done using SPSS Version 21. A total of 632 critically ill patients were admitted in our ICU. Of these 144 (22.8%) had severe acute kidney injury requiring renal replacement therapy. In this subgroup majority (n=107,74.3%) were males. The mean(±sd) age was 58.8(±15.1) years. The majority of these patients presented with fever (51.4%) and breathlessness (73.6%). At the time of initiation of RRT , 128 patients were oliguric. There was a significant difference in hemoglobin (p=0.000), serum albumin (p=0.018) and LDH (p=0.000) levels between the survivors and non survivors. Echocardiography was done in 121 patients, of which 23(19%) showed evidence of regional wall motion abnormality. 48.5% were ventilated invasively and another 8.3% required non-invasive ventilation. The most common RRT modality in these patients was slow low efficiency daily dialysis (40.3%).Nobody was offered peritoneal dialysis. 98(68%) of these patients died. The presence of diabetes mellitus was a poor prognostic indicator.(p=0.017) The clinical parameters associated with mortality were presentation with fever (p=0.04) and breathlessness (p=0.001). Patients on ventilatory support (p=0.00001) and RRT (p=0.00001) had a poorer prognosis. 91% of patients requiring both ventilation and RRT died (p=0.000001). In a multiple regression analysis, older age and the presence regional wall motion abnormality were the only parameters predicting mortality. The type of RRT was not a significant parameter in predicting outcome. Regional wall motion abnormality in echocardiography may signify the presence of myocarditis in these COVID 19 infected patients. Data from our center suggests a very high mortality in COVID 19 infected patients who develop acute kidney injury and undergo renal replacement therapy in the intensive care unit. A better understanding of the prognostic parameters will help us formulate interventions in these critically sick patients in a resource constrained setting." @default.
• W4212907029 created "2022-02-24" @default.
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• W4212907029 date "2022-02-01" @default.
• W4212907029 modified "2023-09-27" @default.
• W4212907029 title "POS-840 Acute kidney injury in critically ill COVID- 19 infected patients requiring renal replacement therapy" @default.
• W4212907029 doi "https://doi.org/10.1016/j.ekir.2022.01.878" @default.
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