Keywords
COVID-19
Intensive Care Units
Peru
Renal dialysis
How to Cite
Abstract
Background: Renal replacement therapy (RRT) is a cornerstone in the treatment and survival of patients with acute kidney injury (AKI) due to COVID-19.
Purpose: To determine the factors of ARF due to COVID-19 associated with RRT in the Intensive Care Unit (ICU) of the Ramiro Prialé Prialé National Hospital of Huancayo, during the period 2020-2021.
Methodology: An analytical observational case-control study was conducted in patients with acute renal failure (ARF) secondary to COVID-19 at the Hospital Nacional Ramiro Prialé Prialé Prialé in Huancayo, Peru, during the period 2020-2021. Cases were defined as those patients with ARF due to COVID-19 who required hemodialysis, while controls were patients with ARF due to COVID-19 who did not receive hemodialysis.
Results: A total of 80 patients were included, 44 (55%) of whom received RRT (cases), and 36 (45%) did not (controls). The majority of patients (68.75%) had stage 3 acute kidney injury. The associated factors identified were: age over 60 years (OR: 1.125, 95% CI 1.044-1.351), male sex (OR: 3.776, 95% CI 1.328-10.733), hospital stay longer than 7 days (OR: 3.905, 95% CI 1.052-16.013), and presence of comorbidities (OR: 2.981, 95% CI 1.185-7.501). Laboratory factors associated with RRT included leukocytosis (OR: 2.684, 95% CI 1.043-6.909), elevated creatinine (OR: 2.660, 95% CI 1.002-7.134), hypoalbuminemia (OR: 2.679, 95% CI 1.074-6.678), and elevated inflammatory markers: procalcitonin (OR: 2.727, 95% CI 1.082-6.876) and LDH (OR: 18.920, 95% CI 2.305-155.376).
Conclusions: There are factors associated with the need for renal replacement therapy in patients with acute kidney injury due to COVID-19 in the ICU of the Ramiro Prialé Prialé National Hospital, Huancayo, during 2020-2021.
References
Ribeiro da Silva SJ, Frutuoso do Nascimento JC, Germano Mendes RP, Miranda Guarines K, Alves da Silva CT, Gomes da Silva P, et al. Two years into the COVID-19 pandemic: lessons learned. ACS Infect Dis. 2022;8(9):1758-814. https://doi.org/10.1021/acsinfecdis.2c00204
Acosta E. Global estimates of excess deaths from COVID-19. Nature. 2023;613(7942):31-3. https://doi.org/10.1038/d41586-022-04138-w
G?owacka M, Lipka S, M?ynarska E, Franczyk B, Rysz J. Acute kidney injury in COVID-19. Int J Mol Sci. 2021;22(15):8081. https://doi.org/10.3390/ijms22158081
Chan L, Chaudhary K, Saha A, Chauhan K, Vaid A, Zhao S, et al. AKI in hospitalized patients with COVID-19. J Am Soc Nephrol. 2021;32(1):151-60. https://doi.org/10.1681/asn.2020050615
Aukland EA, Klepstad P, Aukland SM, Ghavidel FZ, Buanes EA. Acute kidney injury in patients with COVID-19 in the intensive care unit: evaluation of risk factors and mortality in a national cohort. BMJ Open. 2022;12(6):e059046. https://doi.org/10.1136/bmjopen-2021-059046
Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-5. https://doi.org/10.1016/j.ijid.2020.03.017
Petrucelli Doher M, Rodrigues Torres de Carvalho F, Faria Scherer P, Nemoto Matsui T, Luiz Ammirati A, Caldin da Silva B, et al. Acute kidney injury and renal replacement therapy in critically ill COVID-19 patients: risk factors and outcomes: a single-center experience in Brazil. Blood Purif. 2021;50(4-5):520-30. https://doi.org/10.1159/000513425
Meneses-Liendo V, Medina Chávez M, Gómez Lujan M, Cruzalegui Gómez C, Alarcón-Ruiz CA. Insuficiencia renal y hemodiálisis en pacientes hospitalizados con COVID-19 durante la primera ola en Lima, Perú. Acta Méd Peru. 2021;38(4):249-56. http://dx.doi.org/10.35663/amp.2021.384.2169
Venegas-Justiniano Y, Hurtado-Arestegui A, Mucho-Vilca K. Acute renal injury in patients with COVID-19, in the critical care unit of a public hospital, Lima-Peru. medRxiv. 2023;1-17. https://doi.org/10.1101/2023.08.20.23294334
Gainza de los Ríos FJ. Insuficiencia renal aguda. Nefrología al Día. 2012;7:309-34.
Matsumoto K, Prowle JR. COVID-19-associated AKI. Curr Opin Crit Care. 2022;28(6):630-7. https://doi.org/10.1097/mcc.0000000000000988
Zahid U, Ramachandran P, Spitalewitz S, Alasadi L, Chakraborti A, Azhar M, et al. Acute kidney injury in COVID-19 patients: an inner city Hospital experience and policy implications. Am J Nephrol. 2020;51(10):786-96. https://doi.org/10.1159/000511160
Flores Gavino A, Espinoza Anchaygua R, Herrera Añazco P, Rodriguez-Morales AJ. Effect of SARS-COV-2 on kidney tissue: a narrative review. Acta Med Peru. 2021;38(1):53-7. https://doi.org/10.35663/amp.2021.381.1885
Calvo-Alvarez E, D’Alessandro S, Zanotta N, Basilico N, Parapini S, Signorini L, et al. Multiplex array analysis of circulating cytokines and chemokines in COVID-19 patients during the first wave of the SARS-CoV-2 pandemic in Milan, Italy. BMC Immunol. 2024;25(1):49. https://doi.org/10.1186/s12865-024-00641-z
Chen R, Lan Z, Ye J, Pang L, Liu Y, Wu W, et al. Cytokine storm: the primary determinant for the pathophysiological evolution of COVID-19 deterioration. Front Immunol. 2021;12:589095. https://doi.org/10.3389/fimmu.2021.589095
Dessie ZG, Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect Dis. 2021;21(1):855. https://doi.org/10.1186/s12879-021-06536-3
Arellan-Bravo L, León-Gonzales R. Situación de la enfermedad renal crónica en la Región Junín, Perú. Rev Cuerpo Med HNAAA. 2022;15(2):300-1. http://dx.doi.org/10.35434/rcmhnaaa.2022.152.1358
Hunt X, Hameed S, Tetali S, Ngoc LA, Ganle J, Huq L, et al. Impacts of the COVID-19 pandemic on access to healthcare among people with disabilities: evidence from six low- and middle-income countries. Int J Equity Health. 2023;22(1):172. https://doi.org/10.1186/s12939-023-01989-1
Canal 21 Huancayo. Pobreza en Junín aumentó a 24.3% durante el 2023 [internet]. TV Wanka Canal 21 de Huancayo; 2024 [citado 2024, sept. 27]. https://canal21huancayo.com/regional/pobreza-en-junin-aumento-a-24-3-durante-el-2023/
De Francisco ALM, Ronco C. Insuficiencia renal aguda en la infección por COVID-19. Nefrología al Día. 2021:e340.
Hernández-Sampieri R, Mendoza C. Metodologías de la investigación, las rutas cuantitativa, cualitativa y mixta. McGraw Hill; 2018.
Condori A. Factores asociados a lesión renal aguda en pacientes con COVID-19 ingresados en el Hospital Regional del Cusco, 2020 [tesis de grado]. UNSAAC-Institucional; 2021.
Viana-Llamas MC, Arroyo-Espliguero R, Silva-Obregón JA, Uribe-Heredia G, Núñez-Gil I, García-Magallón B, et al. Hypoalbuminemia on admission in COVID-19 infection: an early predictor of mortality and adverse events. A retrospective observational study. Med Clin. 2021;156(9):428-36. https://doi.org/10.1016/j.medcle.2020.12.015
Flores López MG, Soto Tarazona A, De La Cruz-Vargas JA. Distribución regional de mortalidad por Covid-19 en Perú. Rev Fac Med Hum. 2021;21(2):326-34. http://dx.doi.org/10.25176/rfmh.v21i2.3721
Oto OA, Ozturk S, Turgutalp K, Arici M, Alpay N, Merhametsiz O, et al. Predicting the outcome of COVID-19 infection in kidney transplant recipients. BMC Nephrol. 2021;22(1):100. https://doi.org/10.1186/s12882-021-02299-w
Guzmán Sáenz RG, Sáenz López JD, Tatis Villamizar KE. Clinical variables associated with mortality in patients with COVID-19. Rev Colomb Nefrol. 2020;7(supl. 2):368-70. https://doi.org/10.22265/acnef.7.Supl.2.457
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. https://doi.org/10.1016/s0140-6736(20)30566-3
Sosa-García JO, Gutiérrez-Villaseñor AO, García-Briones A, Romero-González JP, Juárez-Hernández E, González-Chon O. Experience in the management of severe COVID-19 patients in an intensive care unit. Cir Cir. 2020;88(5):569-75. https://doi.org/10.24875/ciru.20000675
Contreras-Villamizar K, Barbosa O, Muñoz AC, Suárez JS, González CA, Vargas DC, et al. Risk factors associated with acute kidney injury in a cohort of hospitalized patients with COVID-19. BMC Nephrol. 2023;24(1):140. https://doi.org/10.1186/s12882-023-03172-8
Herrera-Añazco P, Sánchez-Pérez L, Córdova-Cueva L. Prevalencia, características clínicas y evolución de la infección por Covid-19 entre pacientes y personal asistencial de un centro de hemodiálisis de referencia nacional en Perú. Rev Nefrol Dial Transpl. 2021;41(1):42-7. https://www.revistarenal.org.ar/index.php/rndt/article/view/616
Valenzuela Casquino K, Espinoza Venero A, Quispe Galvez JC. Mortalidad y factores pronósticos en pacientes hospitalizados por COVID-19 en la Unidad de Cuidados Intermedios de un hospital público de Lima, Perú. Horiz Med. 2021;21(1):21-6. http://dx.doi.org/10.24265/horizmed.2021.v21n1.05
Bevacqua RJ, Perrone SV. COVID-19: relación entre enzima convertidora de angiotensina 2, sistema cardiovascular y respuesta inmune del huésped. Insuf Card. 2020;15(2):34-51.
Kolhe NV, Fluck RJ, Selby N, Taal MW. Acute kidney injury associated with COVID-19: a retrospective cohort study. PLoS Med. 2020;17(10):e1003406. https://doi.org/10.1371/journal.pmed.1003406
Samaan F, Carneiro de Paula E, Guimarães de Lima Souza FB, Cardoso Mendes LF, Gan Rossi PR, Penalva Freitas RA, et al. COVID-19-associated acute kidney injury patients treated with renal replacement therapy in the intensive care unit: a multicenter study in São Paulo, Brazil. PLoS One. 2022;17(1):e0261958. https://doi.org/10.1371/journal.pone.0261958
Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020;97(5):829-38. https://doi.org/10.1016/j.kint.2020.03.005
Eriksson KE, Campoccia-Jalde F, Rysz S, Rimes-Stigare C. Continuous renal replacement therapy in intensive care patients with COVID-19; survival and renal recovery. J Crit Care. 2021;64:125-30. https://doi.org/10.1016/j.jcrc.2021.04.002
Chan L, Chaudhary K, Saha A, et al. AKI in Hospitalized Patients with COVID-19. J Am Soc Nephrol. 2021;32(1):151-160. https://doi.org/10.1681/asn.2020050615
Chalkias S, McGhee N, Whatley JL, Essink B, Brosz A, Tomassini JE, et al. Safety and immunogenicity of XBB.1.5-Containing mRNA vaccines. medRxiv. 2023:23293434. http://dx.doi.org/10.1101/2023.08.22.23293434
Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 - A systematic review. Life Sci. 2020;254:117788. https://doi.org/10.1016/j.lfs.2020.117788
Ouyang L, Gong Y, Zhu Y, Gong J. Association of acute kidney injury with the severity and mortality of SARS-CoV-2 infection: a meta-analysis. Am J Emerg Med. 2021;43:149-57. https://doi.org/10.1016/j.ajem.2020.08.089
Yucel Kocak S, Ozdemir Kayalar A, Kumbasar Karaosmanoglu H, Yilmaz M. COVID ? 19 in hemodialysis patients: a single ? center experience in Istanbul. Int Urol Nephrol. 2021;53(11):2385-97. https://doi.org/10.1007/s11255-021-02823-9
Tarragón B, Valdenebro M, Serrano ML, Maroto A, Llópez-Carratalá MR, Ramos A, et al. Fracaso renal agudo en pacientes hospitalizados por COVID-19. Nefrología al Día. 2021;41(1):1-90. https://doi.org/10.1016/j.nefro.2020.08.005
Elnagdy MH, Magdy A, Eldars W, Elgamal M, Hazem El-Nagdy A, Salem O, et al. Genetic association of ACE2 and TMPRSS2 polymorphisms with COVID-19 severity; a single centre study from Egypt. Virol J. 2024;21(1):27. https://doi.org/10.1186/s12985-024-02298-x
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.