• Shruti Gupta, Steven G Coca, Lili Chan, Michal L Melamed, Samantha K Brenner, Salim S Hayek, Anne Sutherland, Sonika Puri, Anand Srivastava, Amanda Leonberg-Yoo, Alexandre M Shehata, Jennifer E Flythe, Arash Rashidi, Edward J Schenck, Nitender Goyal, S Susan Hedayati, Rajany Dy, Anip Bansal, Ambarish Athavale, NguyenH BryantHBDivision of Pulmonary, Critical Care, Hyperbaric, Allergy, and Sleep Medicine, Loma Linda University Health, Loma Linda, California., Anitha Vijayan, David M Charytan, Carl E Schulze, Min J Joo, Allon N Friedman, Jingjing Zhang, Marie Anne Sosa, Eric Judd, VelezJuan Carlos QJCQDepartment of Nephrology, Ochsner Health System, New Orleans, Louisiana.Ochsner Clinical School, The University of Queensland, Brisbane, Queensland, Australia., Mary Mallappallil, Roberta E Redfern, Amar D Bansal, Javier A Neyra, Kathleen D Liu, Amanda D Renaghan, Marta Christov, Miklos Z Molnar, Shreyak Sharma, Omer Kamal, Jeffery Owusu Boateng, Samuel A P Short, Andrew J Admon, Meghan E Sise, Wei Wang, Chirag R Parikh, David E Leaf, and STOP-COVID Investigators.
• Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
• J. Am. Soc. Nephrol. 2021 Jan 1; 32 (1): 161-176.

BackgroundAKI is a common sequela of coronavirus disease 2019 (COVID-19). However, few studies have focused on AKI treated with RRT (AKI-RRT).MethodsWe conducted a multicenter cohort study of 3099 critically ill adults with COVID-19 admitted to intensive care units (ICUs) at 67 hospitals across the United States. We used multivariable logistic regression to identify patient-and hospital-level risk factors for AKI-RRT and to examine risk factors for 28-day mortality among such patients.ResultsA total of 637 of 3099 patients (20.6%) developed AKI-RRT within 14 days of ICU admission, 350 of whom (54.9%) died within 28 days of ICU admission. Patient-level risk factors for AKI-RRT included CKD, men, non-White race, hypertension, diabetes mellitus, higher body mass index, higher d-dimer, and greater severity of hypoxemia on ICU admission. Predictors of 28-day mortality in patients with AKI-RRT were older age, severe oliguria, and admission to a hospital with fewer ICU beds or one with greater regional density of COVID-19. At the end of a median follow-up of 17 days (range, 1-123 days), 403 of the 637 patients (63.3%) with AKI-RRT had died, 216 (33.9%) were discharged, and 18 (2.8%) remained hospitalized. Of the 216 patients discharged, 73 (33.8%) remained RRT dependent at discharge, and 39 (18.1%) remained RRT dependent 60 days after ICU admission.ConclusionsAKI-RRT is common among critically ill patients with COVID-19 and is associated with a hospital mortality rate of >60%. Among those who survive to discharge, one in three still depends on RRT at discharge, and one in six remains RRT dependent 60 days after ICU admission.Copyright © 2021 by the American Society of Nephrology.

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