• Murat Küçük, Bişar Ergün, Mehmet Nuri Yakar, Özer Ural Çakıcı, Erdem Yaka, Bilgin Cömert, Ali Necati Gökmen, and Begüm Ergan.
• Department of Internal Medicine and Critical Care, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
• Turk J Med Sci. 2022 Oct 1; 52 (5): 149515031495-1503.

BackgroundAcute kidney injury is strongly associated with mortality in critically ill patients with coronavirus disease 2019 (COVID-19); however, age-related risk factors for acute kidney injury are not clear yet. In this study, it was aimed to evaluate the effects of clinical factors on acute kidney injury development in an elderly COVID-19 patients.MethodsCritically ill patients (≥65years) with COVID-19 admitted to the intensive care unit were included in the study. Primary outcome of the study was the rate of acute kidney injury, and secondary outcome was to define the effect of frailty and other risk factors on acute kidney injury development and mortality.ResultsA total of 132 patients (median age 76 years, 68.2% male) were assessed. Patients were divided into two groups as follows: acute kidney injury (n = 84) and nonacute kidney injury (n = 48). Frailty incidence (48.8% vs. 8.3%, p < 0.01) was higher in the acute kidney injury group. In multivariate analysis, frailty (OR, 3.32, 95% CI, 1.67-6.56), the use of vasopressors (OR, 3.06 95% CI, 1.16-8.08), and the increase in respiratory support therapy (OR, 2.60, 95% CI, 1.01-6.6) were determined to be independent risk factors for acute kidney injury development. The mortality rate was found to be 97.6% in patients with acute kidney injury.DiscussionFrailty is a risk factor for acute kidney injury in geriatric patients with severe COVID-19. The evaluation of geriatric patients based on a frailty scale before intensive care unit admission may improve outcomes.

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