Early renal replacement therapy may Reduce Mortality risk from Severe COVID 19

It was a retrospective study of fifty-eight adult patients in ICU with critically ill or severe COVID-19 with a tendency of critical illness. The ICU medical team determined the early RRT based on a boom in cytokines levels, increased organs injury/failure and rapid aggravation of the condition. All participants were followed up from the first day of ICU admission to March 30, 2020. The major outcome assessed was all-cause mortality in ICU.

Key findings of the study were:

• Among 58 patients, 81.0% had at least one comorbidity before hospitalization.
• The researchers noted that twenty patients were initiated early RRT after 24.1±10.4 days from the onset and 6.4±3.6 days from ICU admission.
• They also noted 34 of 58 patients died during ICU follow-up.
• Upon univariate and multivariate Cox proportional-hazards model, they found that early RRT was associated with a lower risk of all-cause mortality in ICU with an adjusted HR of 0.280.
• They also found that sudden unexpected death (SUD) was remarkably reduced in the early RRT group, compared with the control group (0.2 vs 2.9 per 100 person-day).

The authors concluded, "Early RRT can reduce the all-cause in-hospital mortality, especially SUD in patients with severe COVID-19, but not improve multi-organ impairment or increase the risk of AKI. Early initiation of RRT merits an optional strategy in critically ill patients with COVID-19."

For further information:

https://www.kireports.org/article/S2468-0249(21)00197-2/fulltext