The progress of chronic renal disease patients followed by the diagnosis of COVID-19 in ICU

Year 2022, Volume: 5 Issue: 5, 1443 - 1448, 25.09.2022

Elmas Uysal , Fatih Seğmen , Pınar Ulubaşoğlu , Emine Nilgün Zengin , Deniz Erdem

https://doi.org/10.32322/jhsm.1152051

Cited By: 2

Abstract

Aim: The mortality and morbidity of COVID-19 disease are higher in patients with comorbidities. In this study, we staged patients with chronic renal failure hospitalized in the intensive care unit (ICU) and aimed to evaluate the process of the disease according to the stage of failure.
Material and Method: The medical records of 249 patients followed in Ankara City Hospital MH3 ICU were reviewed retrospectively. The patients were divided into three stages according to their estimated glomerular filtration rate (e-GFR) value (stage 1: e-GFR≥90 ml/min/1.73 m², stage-2: e-GFR: 15-89 ml/min/1.73 m², stage- 3: e-GFR≤15 ml/min/1.73 m²). Data such as age, gender, comorbidity status, length of stay in the ICU, duration of mechanical ventilation, and mortality rate of the patients were recorded. Patients who were evaluated as stage-2 were also classified into 3 stages (stage-2a: e-GFR: 60-89 ml/min/1.73 m², stage-2b: e-GFR:30-59 ml/min/1.73 m², stage-2c: e-GFR: 15-29 ml/min/1.73 m²) and evaluated with the same parameters.
Results: The mean age of all patients was 71 years. It was found that the intubation rate was higher (p=0.012) and the mortality rate was higher (p=0.003) in patients evaluated as stage-3. APACHE II and SOFA scores were higher than the other groups (p=<0.001, p=<0.01). In addition, IL-6, procalcitonin, D-dimer, and ferritin levels were also found to be significantly higher in these patients. Hemoglobin and thrombocyte levels were significantly lower than the other groups. When stage-2 patients were divided into subgroups, it was found that APACHE II and SOFA scores, mechanical ventilation rate, and mortality rate were higher in stage-2c than the other subgroups. While CRP, procalcitonin, and D-dimer values were significantly higher in this group, hemoglobin, thrombocyte, and lymphocyte values were found to be low.
Conclusion: The mortality rate is high in COVID-19 patients with chronic kidney disease(CKD) in ICU. As the stage of the disease increases, the mechanical ventilation rate and mortality rate of the patients increase gradually. For this reason, it may be recommended to be more careful in terms of preventive measures in cases of CKD.

Keywords

COVID-19, chronic kidney disease, mortality, intensive care unit, glomerular filtration rate

Project Number

Yoktur

References

• Aydemir S, Hoşgün D. The role of serum lipoprotein levels in predicting independent short-term mortality in COVID-19 patients. Anatolian Curr Med J 2022; 4; 162-6.
• Zengin EN. Research trends and global productivity on mechanical ventilation with the impact of COVID-19: a bibliometric analysis in the period 1980-2021. J Health Sci Med 2022; 5: 1051-61.
• Arslan K, Baş S. Frequency of troponin elevations in patients with COVID-19 and clinical course in these patients. Anatolian Curr Med J 2022; 4; 95-102.
• Peiris JSM, Chu CM, Cheng VCC. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet 2003; 361: 1767–72.
• Zhou P, Yang XL, Wang XG. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579: 270-3.
• Chu KH, Tsang WK, Tang CS. Acute renal impairment in coronavirus-associated severe acute respiratory syndrome. Kidney Int 2005; 67: 698–705.
• Wang D, Hu B, Hu C. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061–9.
• Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020; 323: 2052–9.
• Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020; 97: 829–38.
• Ülger G, Baldemir R. Analysis of global publications on tracheostomy between 1980 and 2021, including the impact of COVID-19: a bibliometric overview. J Med Palliat Care 2022; 3: 103-10.
• Zengin M, Baldemir R. Investigation of the global outcomes of acute respiratory distress syndrome with the effect of covid-19 in publications: a bibliometric analysis between 1980 and 2020. Kırıkkale Üniversitesi Tıp Fakültesi Derg 2021: 23: 279-92.
• Zengin M, Karcioglu AM. Do not invade, just support. Bratislavske Lekarske Listy 2022: 123; 218-26.
• Baldemir R, Ülger G. A holistic investigation of the global outcomes of spontaneous pneumothorax during 1980-2021, including the COVID-19 pandemic: a bibliometric approach. Medicine (Baltimore) 2022: 101: e29113.
• Portolés J, Marques M, Sánchez PL, De Valdenebro M, Muñez E, Serrano ML. Chronic kidney disease and acute kidney injury in the COVID-19 Spanish outbreak. Nephrol Dial Transplant 2020; 35: 1353–61.
• Cırık MÖ, Baldemir R, Doğanay GE, Ünver M, Avcı S. The 30-day mortality predictor role of c-reactive protein/albumin ratio in critically ill COPD patients. Crit Care Innovat 2020: 3; 1-12.
• Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054–62.
• Ozturk S, Turgutalp K, Arici M, et al. Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: a nationwide analysis from Turkey. Nephrol Dial Transplant 2020; 35: 2083-95
• Wang L, Li X, Chen H, et al. Coronavirus disease 19 infection does not result in acute kidney injury: an analysis of 116 hospitalized patients from Wuhan, China. AJN 2020; 51: 343-8.
• Gabarre P, Dumas G, Dupont T, Darmon M, Azoulay E, Zafrani L. Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med 2020; 46: 1339-48.