POS-037 KIDNEY INVOLVEMENT IN SARS-Co-V-2 INFECTION. A LATIN AMERICAN REGISTRY

Lombardi, R.; Ferreiro, A.; Aroca, G.; Ponce, D.; Rojas, N.; Pereira, M.; Chavez-Iñiguez, J.; Venegas, Y.; Villa, A. P.; Claure-Del Granado, R.; Barnese, M. C.; Guimaraes, C.; Silva, D. J.; Varela, F.; Rizzo-Topete, L.

Introduction: Acute kidney injury (AKI) and urinary sediment alterations are frequently associated to COVID-19, adding severity and high mortality risk. Knowledge of patient characteristics, risk factors, adverse outcomes, and regional peculiarities are key in the fight against this new disease. In order to describe the clinical characteristics of COVID-19 kidney involvement in Latin America (LA), the Latin American Society of Nephrology and Hypertension presents preliminary results of an ongoing Registry. Method(s): Repository of patients (Pts) by open invitation to nephrologists in LA. We included pts with confirmed SARS-CoV-2 infection by RT-PCR who developed proteinuria and/or, hematuria and/or AKI. Pts with CKD stage 5, on chronic dialysis or transplanted were excluded. Surveymonkey platform was used for data entry, and the SPSS v22 was used for the analysis. The study was approved by the Institutional Review Board of Clinica Los Olivos (Cochabamba, Bolivia) and a waiver of written consent was granted. Demographic variables, comorbidities, lab, characteristics and causes of AKI, need for kidney replacement therapy (KRT), ICU admission, mechanical ventilation (MV), complications and in-hospital mortality were collected Results: N= 632 pts. Brazil, Mexico, Colombia, Argentina, Peru and Bolivia were the main providers of pts. Median age 63 yrs (IQR, 53-73). Most pts were male (67.2%). One or more comorbidities were present in 86.9% of cases, mainly hypertension, diabetes and obesity. AKI was hospital-acquired in 59.7% and non-oliguric in 58.5%. Other causes of kidney involvement associated to COVID-19 were volume depletion (38.6%), nephrotoxicity (26.7%), and sepsis (23.4%). KRT was implemented in 47.2% but 32 pts (5.1%) needing dialysis were not dialyzed. Non-recovery of renal function was observed in 65.3%. Sixty-six percent of pts were in ICU and 67.2% underwent MV. However, 3.3% and 2.5% pts needing ICU and MV respectively did not receive it. Proteinuria (PU) at admission was present in 62.5% of 280 evaluable pts. which had more CKD, severity of AKI and the underlying condition and higher mortality rate. In those pts without PU at admission, onset of PU during hospital stay was observed in 15.4% (29/188) which had more hypertension, COVID-19 MODS as cause of AKI, more severe AKI as well as organ dysfunction. Complications in the general population occurred in 79.7%, mainly sepsis (44.9%). All-cause mortality was 57.4%. Variables independently associated to mortality were age (RR 0.95), COVID-19 DOMS (RR 2.46), nephrotoxicity (RR 2.07), oliguria (RR 2.28), non-recovery of AKI (1.97), ICU admisssion (RR 25.6) and MV (2.51). Conclusion(s): This regional cohort of COVID-19 patients showed that kidney involvement is usually found in elderly males patients with associated comorbidities. AKI was predominantly hospital-acquired and non-oliguric. COVID-19 multi-organ dysfunction syndrome (MODS), volume depletion, nephrotoxicity and sepsis were main causes of AKI. Almost half patients required KRT. Of note, a number of pts needing KRT, ICU admission or MV were not treated for not recorded reasons. PU at admission was frequent and associated to CKD, severe clinical condition, worse renal outcomes and increased mortality. In-hospital onset of PU was linked to hypertension, COVID-19 MODS as cause of AKI, and severity of kidney, respiratory and hemodynamic failure. No conflict of interestCopyright © 2021