A Prospective Study of the Course and Outcome of COVID-19 Patients with Acute Kidney Injury Admitted in an Intensive Care Unit.

Wajekar, Shreyas D; Bhat, Shreepad M; Birajdar, Niraj B; Kadam Br, Dileep B

BACKGROUND COVID-19, caused by SARS-COV-2, has been a health emergency of great concern throughout the world. Acute Kidney Injury was reported in a considerable amount of patients suffering from COVID-19, especially in those admitted in the ICU setting. This study was undertaken to study the clinical profile, incidence, severity, requirement of renal replacement therapy, and the outcomes of COVID-19 patients with Acute Kidney Injury admitted in the Intensive Care Unit. MATERIALS AND METHODS A prospective observational study was conducted at a tertiary hospital recognized as Dedicated COVID Hospital during the period of May 2020 to September 2020. 218 patients hospitalised in the Intensive Care Unit during this period were monitored for the development of Acute Kidney Injury. The clinical profile, laboratory findings, requirement of invasive ventilation and renal replacement therapy, and outcomes of such patients were recorded. Data was analysed using the SPSS software. RESULTS Among all the patients enrolled in the Intensive Care Unit during the study period, 27.06% developed Acute Kidney Injury. 67.79% of these patients developed AKI during the first five days of hospitalisation. 76.27% of the patients with AKI required invasive mechanical ventilation, while 28.81% required renal replacement therapy. There was a significant association between the development of Acute Kidney Injury and the requirement of invasive mechanical ventilation (p = 0.0000015). 44.68% of the deaths among the 218 patients were associated with COVID-19 related AKI (p = 0.0000003). CONCLUSION Acute Kidney Injury was found to be common among the hospitalised COVID-19 patients in our Intensive Care Unit. AKI occurs early, often in a temporal association with respiratory failure, and portends a dire prognosis.