Continuous renal replacement therapy in intensive care patients with COVID-19; survival and renal recovery

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Abstract

Outcome for critically ill patients with COVID-19 treated with continuous renal replacement therapy (CRRT) is largely unknown. This observational study was conducted at a university hospital in Sweden. There were studied critically ill adult COVID-19 patients with Acute Kidney injury (AKI) who received continuous renal replacement therapy.

In 451 patients,  Acute Kidney injury incidence was 43.7%. 18.2% received continuous renal replacement therapy. Median age of continuous renal replacement therapy patients was 60 years, 90% were male, median BMI was 29, 23.2% had Diabetes, 37.8% hypertension and 6.1% chronic kidney disease prior to admission. 100% required mechanical ventilation. 8.5% received Extra Corporeal Membrane Oxygenation. Median length of stay was 23 days. Critical patients in intensive care mortality was 39% and 90-day mortality was 45.1%. Age, baseline creatinine values and body weight change were associated with 60 days mortality. Of the survivors, no patients required dialysis at hospital discharge, 73.8% recovered renal function and a median 10.5% of body weight was lost during admission.

Conclusions: Critically ill COVID-19 patients with Acute Kidney injury who received continuous renal replacement therapy  had a 90-day mortality of 45.1%. At follow-up, three quarters of survivors had recovered renal function. This information is important in the clinical management of COVID-19 and further treatment for the critical patients.

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