Guillaume Geri1,2,3,4, Michael Darmon5,6,7, Lara Zafrani5,6,8, Muriel Fartoukh9,10, Guillaume Voiriot9,10,11, Julien Le Marec10,12,13, Saafa Nemlaghi10,12,13, Antoine Vieillard-Baron14,15,16,17, Elie Azoulay5,6,7. 1. Medical Intensive Care Unit, Ambroise Paré Hospital, AP-HP, 9 avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France. guillaume.geri@aphp.fr. 2. Paris Saclay University, Gif-sur-Yvette, France. guillaume.geri@aphp.fr. 3. INSERM UMR 1018, CESP, Villejuif, France. guillaume.geri@aphp.fr. 4. FHU SEPSIS, Saclay, France. guillaume.geri@aphp.fr. 5. Medical Intensive Care Unit, Saint Louis Hospital, AP-HP, Paris, France. 6. Paris University, Paris, France. 7. INSERM U1153, Centre of Research in Epidemiology and Statistics, Paris, France. 8. INSERM U976, Immunologie Humaine, Pathophysiologie et immunothérapie, Paris, France. 9. Medical Intensive Care Unit, Tenon Hospital, AP-HP, Paris, France. 10. Paris Sorbonne University, Paris, France. 11. INSERM U955 (IMRB), Equipe GEIC2O, 94000, Créteil, France. 12. Medical Intensive Care Unit, Pitié-Salpétrière Hospital, AP-HP, Paris, France. 13. INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France. 14. Medical Intensive Care Unit, Ambroise Paré Hospital, AP-HP, 9 avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France. 15. Paris Saclay University, Gif-sur-Yvette, France. 16. INSERM UMR 1018, CESP, Villejuif, France. 17. FHU SEPSIS, Saclay, France.
Abstract
BACKGROUND: While acute kidney injury (AKI) is frequent in severe SARS-CoV2-related pneumonia ICU patients, few data are still available about its risk factors. METHODS: Retrospective observational study performed in four university affiliated hospitals in Paris. AKI was defined according to the KIDGO guidelines. Factors associated with AKI were picked up using multivariable mixed-effects logistic regression. Independent risk factors of day 28 mortality were assessed using Cox model. RESULTS: 379 patients (median age 62 [53,69], 77% of male) were included. Half of the patients had AKI (n = 195, 52%) including 58 patients (15%) with AKI stage 1, 44 patients (12%) with AKI stage 2, and 93 patients (25% with AKI stage 3). Chronic kidney disease (OR 7.41; 95% CI 2.98-18.4), need for invasive mechanical ventilation at day 1 (OR 4.83; 95% CI 2.26-10.3), need for vasopressors at day 1 (OR 2.1; 95% CI 1.05-4.21) were associated with increased risk of AKI. Day 28 mortality in the cohort was 26.4% and was higher in patients with AKI (37.4 vs. 14.7%, P < 0.001). Neither AKI (HR 1.35; 95% CI 0.78-2.32) nor AKI stage were associated with mortality (HR [95% CI] for stage 1, 2 and 3 when compared to no AKI of, respectively, 1.02 [0.49-2.10], 1.73 [0.81-3.68] and 1.42 [0.78-2.58]). CONCLUSION: In this large cohort of SARS-CoV2-related pneumonia patients admitted to the ICU, AKI was frequent, mostly driven by preexisting chronic kidney disease and life sustaining therapies, with unclear adjusted relationship with day 28 outcome.
BACKGROUND: While acute kidney injury (AKI) is frequent in severe SARS-CoV2-related pneumonia ICU patients, few data are still available about its risk factors. METHODS: Retrospective observational study performed in four university affiliated hospitals in Paris. AKI was defined according to the KIDGO guidelines. Factors associated with AKI were picked up using multivariable mixed-effects logistic regression. Independent risk factors of day 28 mortality were assessed using Cox model. RESULTS: 379 patients (median age 62 [53,69], 77% of male) were included. Half of the patients had AKI (n = 195, 52%) including 58 patients (15%) with AKI stage 1, 44 patients (12%) with AKI stage 2, and 93 patients (25% with AKI stage 3). Chronic kidney disease (OR 7.41; 95% CI 2.98-18.4), need for invasive mechanical ventilation at day 1 (OR 4.83; 95% CI 2.26-10.3), need for vasopressors at day 1 (OR 2.1; 95% CI 1.05-4.21) were associated with increased risk of AKI. Day 28 mortality in the cohort was 26.4% and was higher in patients with AKI (37.4 vs. 14.7%, P < 0.001). Neither AKI (HR 1.35; 95% CI 0.78-2.32) nor AKI stage were associated with mortality (HR [95% CI] for stage 1, 2 and 3 when compared to no AKI of, respectively, 1.02 [0.49-2.10], 1.73 [0.81-3.68] and 1.42 [0.78-2.58]). CONCLUSION: In this large cohort of SARS-CoV2-related pneumoniapatients admitted to the ICU, AKI was frequent, mostly driven by preexisting chronic kidney disease and life sustaining therapies, with unclear adjusted relationship with day 28 outcome.
Authors: Ronaldo C Go; Themba Nyirenda; Maryam Bojarian; Davood K Hosseini; Kevin Kim; Mehek Rahim; Elli G Paleoudis; Anna C Go; Zhiyong Han; Steven J Sperber; Anjali Gupta Journal: BMC Infect Dis Date: 2022-03-14 Impact factor: 3.090
Authors: Greet De Vlieger; Eric Hoste; Hannah Schaubroeck; Wim Vandenberghe; Willem Boer; Eva Boonen; Bram Dewulf; Camille Bourgeois; Jasperina Dubois; Alexander Dumoulin; Tom Fivez; Jan Gunst; Greet Hermans; Piet Lormans; Philippe Meersseman; Dieter Mesotten; Björn Stessel; Marc Vanhoof Journal: Crit Care Date: 2022-07-25 Impact factor: 19.334