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Article Dans Une Revue Clinical Kidney Journal Année : 2020

Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019

Arthur Orieux
  • Fonction : Auteur
Renaud Prevel
  • Fonction : Auteur
Sandrine Dabernat
Fabrice Camou
  • Fonction : Auteur
Nahema Issa
  • Fonction : Auteur
Antoine Dewitte
  • Fonction : Auteur
Olivier Joannes-Boyau
Catherine Fleureau
  • Fonction : Auteur
Hadrien Rozé
  • Fonction : Auteur
Laurent Petit
  • Fonction : Auteur
Hoang-Nam Bui
  • Fonction : Auteur
Odile Pillet
  • Fonction : Auteur
Christian Combe
Didier Gruson
  • Fonction : Auteur

Résumé

Abstract Background Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) frequency, severity and characterization in critically ill patients has not been reported. Methods Single-centre cohort performed from 3 March 2020 to 14 April 2020 in four intensive care units in Bordeaux University Hospital, France. All patients with COVID-19 and pulmonary severity criteria were included. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterization (transient versus persistent AKI; proteinuria, haematuria and glycosuria) and short-term outcomes were evaluated. Results Seventy-one patients were included, with basal serum creatinine (SCr) of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median [interquartile range (IQR)] follow-up was 17 (12–23) days. AKI developed in a total of 57/71 (80%) patients, with 35% Stage 1, 35% Stage 2 and 30% Stage 3 AKI; 10/57 (18%) required renal replacement therapy (RRT). Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median (IQR) urine protein/creatinine of 82 (54–140) (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20, indicating predominant tubulointerstitial injury. Only two (4%) patients had glycosuria. At Day 7 after onset of AKI, six (11%) patients remained dependent on RRT, nine (16%) had SCr >200 µmol/L and four (7%) had died. Day 7 and Day 14 renal recovery occurred in 28% and 52%, respectively. Conclusion Severe COVID-19-associated AKI is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria.
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Dates et versions

hal-03194408 , version 1 (09-04-2021)

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Paternité - Pas d'utilisation commerciale

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Sebastien Rubin, Arthur Orieux, Renaud Prevel, Antoine Garric, Marie-Lise Bats, et al.. Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019. Clinical Kidney Journal, 2020, 13 (3), pp.354-361. ⟨10.1093/ckj/sfaa099⟩. ⟨hal-03194408⟩

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