Key points are not available for this paper at this time.
Abstract Introduction Acute kidney injury (AKI) is linked to disease severity and prognosis in patients with coronavirus disease 2019 (COVID-19), and mortality increases even with milder stages. This study primarily investigated the effects of continuous renal replacement therapy (CRRT) timing on intensive care unit (ICU) mortality in patients with COVID-19 with acute respiratory distress syndrome (ARDS) and AKI. Secondary goals were secondary goals for the ICU, days without life support treatment, and change in post-CRRT day biomarker levels, the length of ICU and overall hospital stay. Methods In this retrospective study, patients with COVID-19 with ARDS and AKI were divided into CRRT initiated at AKI stages 1 and 2, early-CRRT (E-CRRT) and AKI stage 3, late-CRRT (L-CRRT) and followed until discharge or death. Results E-CRRT had 20 patients and L-CRRT had 18 patients. No association between CRRT timing and ICU mortality was detected ( p = 0.724). Moreover, the timing was not associated with ICU, total hospital stay, or days without life support treatment. However, it was associated with D-dimer levels for both groups and ferritin and C-reactive protein (CRP) levels for E-CRRT. There were no associations for other markers, such as procalcitonin, troponin T, pro-brain natriuretic peptide (pro-BNP), interleukin-6, fibrinogen, or antithrombin III levels. Conclusions CRRT timing was not associated with ICU mortality, total hospital stay, or days without life support treatment in this cohort. For E-CRRT, ferritin and CRP levels, and for both groups, D-dimer levels, were associated with CRRT timing. Randomized controlled trials are needed to examine the effects of CRRT timing in patients with COVID-19 with ARDS and AKI.
Tuna et al. (Fri,) studied this question.