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Extra-renal purification in COVID-19 patients with acute kidney injury in intensive care unit: experience of the Grand Hôpital de l’Est Francilien, Meaux site during the first four waves of the pandemic


Khazy Muamba Anga
Jean Robert Rissassy Makulo
Ernest Kiswaya Sumaili
Éric Amisi
Christel Isengingo
Wilfrid Mbombo
Médard Bula-Bula
Vivien Hong Tuan Ha
Aliocha Natuhoyila Nkodila
Berthe Barhayiga

Abstract

Context and objective. Patients with COVID-19 admitted to intensive care sometimes require extra-renal purification (ERP) for various indications. However, the related data are paradoxically non-existent. The aim of the present study was to describe the extent and survival to the use of ERP. Methods. This was a historical cohort study focusing on patients with COVID-19 admitted to the multipurpose intensive care unit of the Grand Hôpital de l'Est Ile-de-France, Meaux site, during the period from March 2020 to December 2021. Patient survival was described by the Kaplan-Meier curves, and the different curves compared using the Log-rank test. Predictors of death were sought using Cox regression. Results. In total, 202 patients (mean age 63 ± 13.9 years, male sex 64.4%) were included. The prevalence of ERP was 29.2% in the entire cohort. Indications for ERP included oligoanuria, hyperkalemia and acute pulmonary edema. The techniques used were hemofiltration (69.4%), hemodiafiltration (13.5%) and hemodialysis (16.9%) and citrate represented the majority anticoagulant (79.7%). Survival probabilities were 94.8% at day 2, 78.9% at day 7, 68.0% at day 14 and 64.4% at day 21. The mortality rate was higher in patients who received hemodiafiltration (71.4%). Survival was also shorter in the hemodiafiltration group. Conclusion. Acute kidney injury is common in intensive care in patients with COVID-19, with notable recourse to ERP.


Received: November 16th, 2024


Accepted: January 28th, 2025


https://dx.doi.org/10.4314/aamed.v18i2.4


Journal Identifiers


eISSN: 2313-3589
print ISSN: 2309-5784