{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T08:15:07Z","timestamp":1767860107624,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T00:00:00Z","timestamp":1615766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Critically ill patients with COVID-19 are prone to develop severe acute kidney injury (AKI), defined as KDIGO (Kidney Disease Improving Global Outcomes) stages 2 or 3. However, data are limited in these patients. We aimed to report the incidence, risk factors, and prognostic impact of severe AKI in critically ill patients with COVID-19 admitted to the intensive care unit (ICU) for acute respiratory failure. Methods: A retrospective monocenter study including adult patients with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection admitted to the ICU for acute respiratory failure. The primary outcome was to identify the incidence and risk factors associated with severe AKI (KDIGO stages 2 or 3). Results: Overall, 110 COVID-19 patients were admitted. Among them, 77 (70%) required invasive mechanical ventilation (IMV), 66 (60%) received vasopressor support, and 9 (8.2%) needed extracorporeal membrane oxygenation (ECMO). Severe AKI occurred in 50 patients (45.4%). In multivariable logistic regression analysis, severe AKI was independently associated with age (odds ratio (OR) = 1.08 (95% CI (confidence interval): 1.03\u20131.14), p = 0.003), IMV (OR = 33.44 (95% CI: 2.20\u2013507.77), p = 0.011), creatinine level on admission (OR = 1.04 (95% CI: 1.008\u20131.065), p = 0.012), and ECMO (OR = 11.42 (95% CI: 1.95\u201366.70), p = 0.007). Inflammatory (interleukin-6, C-reactive protein, and ferritin) or thrombotic (D-dimer and fibrinogen) markers were not associated with severe AKI after adjustment for potential confounders. Severe AKI was independently associated with hospital mortality (OR = 29.73 (95% CI: 4.10\u2013215.77), p = 0.001) and longer hospital length of stay (subhazard ratio = 0.26 (95% CI: 0.14\u20130.51), p &lt; 0.001). At the time of hospital discharge, 74.1% of patients with severe AKI who were discharged alive from the hospital recovered normal or baseline renal function. Conclusion: Severe AKI was common in critically ill patients with COVID-19 and was not associated with inflammatory or thrombotic markers. Severe AKI was an independent risk factor of hospital mortality and hospital length of stay, and it should be rapidly recognized during SARS-CoV-2 infection.<\/jats:p>","DOI":"10.3390\/jcm10061217","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T11:38:58Z","timestamp":1615808338000},"page":"1217","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Severe Acute Kidney Injury in Critically Ill Patients with COVID-19 Admitted to ICU: Incidence, Risk Factors, and Outcomes"],"prefix":"10.3390","volume":"10","author":[{"given":"Muriel","family":"Ghosn","sequence":"first","affiliation":[{"name":"Medical Sub-Specialties Institute, Department of Nephrology, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nizar","family":"Attallah","sequence":"additional","affiliation":[{"name":"Medical Sub-Specialties Institute, Department of Nephrology, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"},{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Badr","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"De Oliveira","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf","family":"Nadeem","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeldho","family":"Varghese","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dnyaseshwar","family":"Munde","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shameen","family":"Salam","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baraa","family":"Abduljawad","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Saleh","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussam","family":"Elkambergy","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Wahla","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Taha","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0866-2194","authenticated-orcid":false,"given":"Jamil","family":"Dibu","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Bayrlee","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadi","family":"Hamed","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadeem","family":"Rahman","sequence":"additional","affiliation":[{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6372-7360","authenticated-orcid":false,"given":"Jihad","family":"Mallat","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44195, USA"},{"name":"Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates"},{"name":"Faculty of Medicine, Normandy University, UNICAEN, ED 497, 1400 Caen, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in china: Summary of a report of 72,314 cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S2213-2600(20)30079-5","article-title":"Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study","volume":"8","author":"Yang","year":"2020","journal-title":"Lancet Respir. 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