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Acute kidney injury in patients with COVID-19 in the critical care unit of a public hospital, Lima, Peru

Justiniano Y.V.; Vilca K.M.; Aréstegui A.H. · Revista Colombiana de Nefrologia (2025) · DOI: 10.22265/acnef.12.3.886

Resumen

Background: COVID-19 infection has been associated with a significant increase in renal complications, especially in critically ill patients. Acute kidney injury (AKI) in this group is a marker of clinical compromise and is associated with high mortality in intensive care units (ICUs). Purpose: To determine the clinical and laboratory characteristics, as well as evaluating the factors associated with mortality in patients with COVID-19 infection and acute kidney injury (AKI) hospitalized in the Intensive Care Unit (ICU) of the Hospital Nacional Arzobispo Loayza. Methodology: Retrospective cohort study, with convenience sampling during the period from April 2020 to March 2021, through the review of medical records data. Inclusion criteria were; patients ≥ 18 years old, with a diagnosis of COVID-19 infection, who were admitted to ICU with normal renal function and developed AKI during their stay in ICU. Exclusion criteria were; patients who developed AKI prior to ICU admission, patients with chronic kidney disease with and without dialysis. Results: A total of 177 medical records that met the inclusion and exclusion criteria were evaluated. The mean age was 57.2±13.2 years, 145 (81.4 %) were male; comorbidities were: obesity 112(63.3 %), arterial hypertension 55 (31.1 %) and diabetes mellitus 30(16.9 %); the most frequent cause of AKI was hypoperfusion 93 %. 83 participants (46.8 %) received dialytic support in the intermittent hemodialysis modality. In-hospital mortality was 151 (85.3 %) and higher in the group with stage 3 AKI: 109 (72.2 %). The increase in ferritin level (OR: 4.42 (IC95 % 4.31-18.44), p<0,001) and APACHE score (OR: 2.41 (IC95 % 1.18-4.93), p<0,016), as well as the decrease in PaO2 /Fi O2 level (OR: 0.85 (IC95 % 0.52-0.92), p<0.042), were related to mortality. Conclusions: AKI in ICU patients with COVID-19 infection has a high mortality and the related factors were the increase in APACHE II score and ferritin level, as well as the decrease in PaO2 /Fi O2 level.

Instituciones: Universidad Peruana Cayetano Heredia