• Michael Kuniavsky, Keren Doenyas-Barak, Nethanel Goldschmidt, Amit Huppert, Olga Bronshtein, Chana Rosenfelder, Laurence S Freedman, and Yaron Niv.
• Division of Quality and Safety, Ministry of Health, 39 Yirmeyahu Street, 446724, Jerusalem, Israel. michael.kuniavsky@moh.gov.il.
• J Gen Intern Med. 2022 Sep 1; 37 (12): 3128-3133.

IntroductionRenal failure (RF) is a risk factor for mortality among hospitalized patients. However, its role in COVID-19-related morbidity and mortality is inconclusive. The aim of the study was to determine whether RF is a significant predictor of clinical outcomes in COVID-19 hospitalized patients based on a retrospective, nationwide, cohort study.MethodsThe study sample consisted of patients hospitalized in Israel for COVID-19 in two periods. A random sample of these admissions was selected, and experienced nurses extracted the data from the electronic files. The group with RF on admission was compared to the group of patients without RF. The association of RF with 30-day mortality was investigated using a logistic regression model.ResultsDuring the two periods, 19,308 and 2994 patients were admitted, from which a random sample of 4688 patients was extracted. The 30-day mortality rate for patients with RF was 30% (95% confidence interval (CI): 27-33%) compared to 8% (95% CI: 7-9%) among patients without RF. The estimated OR for 30-day mortality among RF versus other patients was 4.3 (95% CI: 3.7-5.1) and after adjustment for confounders was 2.2 (95% CI: 1.8-2.6). Furthermore, RF patients received treatment by vasopressors and invasive mechanical ventilation (IMV) more frequently than those without RF (vasopressors: 17% versus 6%, OR = 2.8, p<0.0001; IMV: 17% versus 7%, OR = 2.6, p<0.0001).DiscussionRF is an independent risk factor for mortality, IMV, and the need for vasopressors among patients hospitalized for COVID-19 infection. Therefore, this condition requires special attention when considering preventive tools, monitoring, and treatment.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

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