Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019.
Identifieur interne : 001371 ( Main/Exploration ); précédent : 001370; suivant : 001372Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019.
Auteurs : Sébastien Rubin [France] ; Arthur Orieux [France] ; Renaud Prevel [France] ; Antoine Garric [France] ; Marie-Lise Bats [France] ; Sandrine Dabernat [France] ; Fabrice Camou [France] ; Olivier Guisset [France] ; Nahema Issa [France] ; Gaelle Mourissoux [France] ; Antoine Dewitte [France] ; Olivier Joannes-Boyau [France] ; Catherine Fleureau [France] ; Hadrien Rozé [France] ; Cédric Carrié [France] ; Laurent Petit [France] ; Benjamin Clouzeau [France] ; Charline Sazio [France] ; Hoang-Nam Bui [France] ; Odile Pillet [France] ; Claire Rigothier [France] ; Frederic Vargas [France] ; Christian Combe [France] ; Didier Gruson [France] ; Alexandre Boyer [France]Source :
- Clinical kidney journal [ 2048-8505 ] ; 2020.
Abstract
Background
Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) frequency, severity and characterization in critically ill patients has not been reported.
Methods
Single-centre cohort performed from 3 March 2020 to 14 April 2020 in four intensive care units in Bordeaux University Hospital, France. All patients with COVID-19 and pulmonary severity criteria were included. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterization (transient versus persistent AKI; proteinuria, haematuria and glycosuria) and short-term outcomes were evaluated.
Results
Seventy-one patients were included, with basal serum creatinine (SCr) of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median [interquartile range (IQR)] follow-up was 17 (12-23) days. AKI developed in a total of 57/71 (80%) patients, with 35% Stage 1, 35% Stage 2 and 30% Stage 3 AKI; 10/57 (18%) required renal replacement therapy (RRT). Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median (IQR) urine protein/creatinine of 82 (54-140) (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20, indicating predominant tubulointerstitial injury. Only two (4%) patients had glycosuria. At Day 7 after onset of AKI, six (11%) patients remained dependent on RRT, nine (16%) had SCr >200 µmol/L and four (7%) had died. Day 7 and Day 14 renal recovery occurred in 28% and 52%, respectively.
Conclusion
Severe COVID-19-associated AKI is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria.
DOI: 10.1093/ckj/sfaa099
PubMed: 32695326
PubMed Central: PMC7314187
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Cedric" sort="Carrie, Cedric" uniqKey="Carrie C" first="Cédric" last="Carrié">Cédric Carrié</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Petit, Laurent" sort="Petit, Laurent" uniqKey="Petit L" first="Laurent" last="Petit">Laurent Petit</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Clouzeau, Benjamin" sort="Clouzeau, Benjamin" uniqKey="Clouzeau B" first="Benjamin" last="Clouzeau">Benjamin Clouzeau</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Sazio, Charline" sort="Sazio, Charline" uniqKey="Sazio C" first="Charline" last="Sazio">Charline Sazio</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Bui, Hoang Nam" sort="Bui, Hoang Nam" uniqKey="Bui H" first="Hoang-Nam" last="Bui">Hoang-Nam Bui</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Pillet, Odile" sort="Pillet, Odile" uniqKey="Pillet O" first="Odile" last="Pillet">Odile Pillet</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Rigothier, Claire" sort="Rigothier, Claire" uniqKey="Rigothier C" first="Claire" last="Rigothier">Claire Rigothier</name><affiliation wicri:level="3"><nlm:affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Vargas, Frederic" sort="Vargas, Frederic" uniqKey="Vargas F" first="Frederic" last="Vargas">Frederic Vargas</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Combe, Christian" sort="Combe, Christian" uniqKey="Combe C" first="Christian" last="Combe">Christian Combe</name><affiliation wicri:level="3"><nlm:affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Gruson, Didier" sort="Gruson, Didier" uniqKey="Gruson D" first="Didier" last="Gruson">Didier Gruson</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Boyer, Alexandre" sort="Boyer, Alexandre" uniqKey="Boyer A" first="Alexandre" last="Boyer">Alexandre Boyer</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32695326</idno><idno type="pmid">32695326</idno><idno type="doi">10.1093/ckj/sfaa099</idno><idno type="pmc">PMC7314187</idno><idno type="wicri:Area/Main/Corpus">000877</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000877</idno><idno type="wicri:Area/Main/Curation">000877</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000877</idno><idno type="wicri:Area/Main/Exploration">000877</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019.</title><author><name sortKey="Rubin, Sebastien" sort="Rubin, Sebastien" uniqKey="Rubin S" first="Sébastien" last="Rubin">Sébastien Rubin</name><affiliation wicri:level="3"><nlm:affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Unité INSERM U1034, Université de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Unité INSERM U1034, Université de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName><orgName type="university">Université de Bordeaux</orgName></affiliation></author><author><name sortKey="Orieux, Arthur" sort="Orieux, Arthur" uniqKey="Orieux A" first="Arthur" last="Orieux">Arthur Orieux</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Prevel, Renaud" sort="Prevel, Renaud" uniqKey="Prevel R" first="Renaud" last="Prevel">Renaud Prevel</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Garric, Antoine" sort="Garric, Antoine" uniqKey="Garric A" first="Antoine" last="Garric">Antoine Garric</name><affiliation wicri:level="3"><nlm:affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Bats, Marie Lise" sort="Bats, Marie Lise" uniqKey="Bats M" first="Marie-Lise" last="Bats">Marie-Lise Bats</name><affiliation wicri:level="3"><nlm:affiliation>Service de Biochimie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Biochimie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Unité INSERM U1034, Université de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Unité INSERM U1034, Université de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName><orgName type="university">Université de Bordeaux</orgName></affiliation></author><author><name sortKey="Dabernat, Sandrine" sort="Dabernat, Sandrine" uniqKey="Dabernat S" first="Sandrine" last="Dabernat">Sandrine Dabernat</name><affiliation wicri:level="3"><nlm:affiliation>Service de Biochimie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Biochimie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Camou, Fabrice" sort="Camou, Fabrice" uniqKey="Camou F" first="Fabrice" last="Camou">Fabrice Camou</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Guisset, Olivier" sort="Guisset, Olivier" uniqKey="Guisset O" first="Olivier" last="Guisset">Olivier Guisset</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Issa, Nahema" sort="Issa, Nahema" uniqKey="Issa N" first="Nahema" last="Issa">Nahema Issa</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Mourissoux, Gaelle" sort="Mourissoux, Gaelle" uniqKey="Mourissoux G" first="Gaelle" last="Mourissoux">Gaelle Mourissoux</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Dewitte, Antoine" sort="Dewitte, Antoine" uniqKey="Dewitte A" first="Antoine" last="Dewitte">Antoine Dewitte</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Joannes Boyau, Olivier" sort="Joannes Boyau, Olivier" uniqKey="Joannes Boyau O" first="Olivier" last="Joannes-Boyau">Olivier Joannes-Boyau</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Fleureau, Catherine" sort="Fleureau, Catherine" uniqKey="Fleureau C" first="Catherine" last="Fleureau">Catherine Fleureau</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Roze, Hadrien" sort="Roze, Hadrien" uniqKey="Roze H" first="Hadrien" last="Rozé">Hadrien Rozé</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Carrie, Cedric" sort="Carrie, Cedric" uniqKey="Carrie C" first="Cédric" last="Carrié">Cédric Carrié</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Petit, Laurent" sort="Petit, Laurent" uniqKey="Petit L" first="Laurent" last="Petit">Laurent Petit</name><affiliation wicri:level="3"><nlm:affiliation>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Clouzeau, Benjamin" sort="Clouzeau, Benjamin" uniqKey="Clouzeau B" first="Benjamin" last="Clouzeau">Benjamin Clouzeau</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Sazio, Charline" sort="Sazio, Charline" uniqKey="Sazio C" first="Charline" last="Sazio">Charline Sazio</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Bui, Hoang Nam" sort="Bui, Hoang Nam" uniqKey="Bui H" first="Hoang-Nam" last="Bui">Hoang-Nam Bui</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Pillet, Odile" sort="Pillet, Odile" uniqKey="Pillet O" first="Odile" last="Pillet">Odile Pillet</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Rigothier, Claire" sort="Rigothier, Claire" uniqKey="Rigothier C" first="Claire" last="Rigothier">Claire Rigothier</name><affiliation wicri:level="3"><nlm:affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Vargas, Frederic" sort="Vargas, Frederic" uniqKey="Vargas F" first="Frederic" last="Vargas">Frederic Vargas</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Combe, Christian" sort="Combe, Christian" uniqKey="Combe C" first="Christian" last="Combe">Christian Combe</name><affiliation wicri:level="3"><nlm:affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Gruson, Didier" sort="Gruson, Didier" uniqKey="Gruson D" first="Didier" last="Gruson">Didier Gruson</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Boyer, Alexandre" sort="Boyer, Alexandre" uniqKey="Boyer A" first="Alexandre" last="Boyer">Alexandre Boyer</name><affiliation wicri:level="3"><nlm:affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author></analytic><series><title level="j">Clinical kidney journal</title><idno type="ISSN">2048-8505</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Background</b></p><p>Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) frequency, severity and characterization in critically ill patients has not been reported.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>Single-centre cohort performed from 3 March 2020 to 14 April 2020 in four intensive care units in Bordeaux University Hospital, France. All patients with COVID-19 and pulmonary severity criteria were included. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterization (transient versus persistent AKI; proteinuria, haematuria and glycosuria) and short-term outcomes were evaluated.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Seventy-one patients were included, with basal serum creatinine (SCr) of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median [interquartile range (IQR)] follow-up was 17 (12-23) days. AKI developed in a total of 57/71 (80%) patients, with 35% Stage 1, 35% Stage 2 and 30% Stage 3 AKI; 10/57 (18%) required renal replacement therapy (RRT). Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median (IQR) urine protein/creatinine of 82 (54-140) (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20, indicating predominant tubulointerstitial injury. Only two (4%) patients had glycosuria. At Day 7 after onset of AKI, six (11%) patients remained dependent on RRT, nine (16%) had SCr >200 µmol/L and four (7%) had died. Day 7 and Day 14 renal recovery occurred in 28% and 52%, respectively.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>Severe COVID-19-associated AKI is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32695326</PMID><DateRevised><Year>2020</Year><Month>07</Month><Day>23</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">2048-8505</ISSN><JournalIssue CitedMedium="Print"><Volume>13</Volume><Issue>3</Issue><PubDate><Year>2020</Year><Month>Jun</Month></PubDate></JournalIssue><Title>Clinical kidney journal</Title><ISOAbbreviation>Clin Kidney J</ISOAbbreviation></Journal><ArticleTitle>Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019.</ArticleTitle><Pagination><MedlinePgn>354-361</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/ckj/sfaa099</ELocationID><Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) frequency, severity and characterization in critically ill patients has not been reported.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">Single-centre cohort performed from 3 March 2020 to 14 April 2020 in four intensive care units in Bordeaux University Hospital, France. All patients with COVID-19 and pulmonary severity criteria were included. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterization (transient versus persistent AKI; proteinuria, haematuria and glycosuria) and short-term outcomes were evaluated.</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">Seventy-one patients were included, with basal serum creatinine (SCr) of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median [interquartile range (IQR)] follow-up was 17 (12-23) days. AKI developed in a total of 57/71 (80%) patients, with 35% Stage 1, 35% Stage 2 and 30% Stage 3 AKI; 10/57 (18%) required renal replacement therapy (RRT). Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median (IQR) urine protein/creatinine of 82 (54-140) (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20, indicating predominant tubulointerstitial injury. Only two (4%) patients had glycosuria. At Day 7 after onset of AKI, six (11%) patients remained dependent on RRT, nine (16%) had SCr >200 µmol/L and four (7%) had died. Day 7 and Day 14 renal recovery occurred in 28% and 52%, respectively.</AbstractText><AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">Severe COVID-19-associated AKI is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria.</AbstractText><CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rubin</LastName><ForeName>Sébastien</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0002-1246-0712</Identifier><AffiliationInfo><Affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Unité INSERM U1034, Université de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Orieux</LastName><ForeName>Arthur</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prevel</LastName><ForeName>Renaud</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Garric</LastName><ForeName>Antoine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bats</LastName><ForeName>Marie-Lise</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Service de Biochimie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Unité INSERM U1034, Université de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dabernat</LastName><ForeName>Sandrine</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Service de Biochimie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Camou</LastName><ForeName>Fabrice</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guisset</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Issa</LastName><ForeName>Nahema</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mourissoux</LastName><ForeName>Gaelle</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dewitte</LastName><ForeName>Antoine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Joannes-Boyau</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fleureau</LastName><ForeName>Catherine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rozé</LastName><ForeName>Hadrien</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Service d'Anesthésie-Réanimation Sud, Centre Médico-Chirurgical Magellan, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carrié</LastName><ForeName>Cédric</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Petit</LastName><ForeName>Laurent</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Service d'Anesthésie-Réanimation, Pellegrin CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clouzeau</LastName><ForeName>Benjamin</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sazio</LastName><ForeName>Charline</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bui</LastName><ForeName>Hoang-Nam</ForeName><Initials>HN</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pillet</LastName><ForeName>Odile</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rigothier</LastName><ForeName>Claire</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vargas</LastName><ForeName>Frederic</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Combe</LastName><ForeName>Christian</ForeName><Initials>C</Initials><Identifier Source="ORCID">0000-0002-0360-573X</Identifier><AffiliationInfo><Affiliation>Service de Néphrologie, Transplantation, Dialyse et Aphérèses, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gruson</LastName><ForeName>Didier</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boyer</LastName><ForeName>Alexandre</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de Médecine Intensive Réanimation, Hôpital Pellegrin et Hôpital Saint André, CHU de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Clin Kidney J</MedlineTA><NlmUniqueID>101579321</NlmUniqueID><ISSNLinking>2048-8505</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">acute interstitial nephritis</Keyword><Keyword MajorTopicYN="N">acute kidney injury</Keyword><Keyword MajorTopicYN="N">acute tubular injury</Keyword><Keyword MajorTopicYN="N">critically ill patients</Keyword><Keyword MajorTopicYN="N">renal replacement therapy</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>06</Day></PubMedPubDate><PubMedPubDate 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last="Vargas">Frederic Vargas</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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