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Table 4 Association between cumulative fluid balance during the first 48 h after hospital admission and the development of new AKI and KRT

From: Changing epidemiology of acute kidney injury in critically ill patients with COVID-19: a prospective cohort

 

Outcome: new AKI [OR (95% CI)] (n = 420)a

 

Unadjusted

Adjusted

Cumulative FB at 48 h

  

 < − 2% (n = 20)

0.76 (0.26, 2.19)

0.80 (0.26, 2.47)

 − 2% to 0% (n = 128)

1.40 (0.87, 2.27)

1.57 (0.92, 2.65)

 0% to + 2% (n = 180)

Reference

Reference

 >  + 2% (n = 92)

3.08 (1.83, 5.20)***

2.55 (1.46, 4.50) **

Invasive ventilation

–

1.32 (0.62, 2.84)

Remdesivir

–

0.79 (0.45, 1.38)

Steroids

–

1.49 (0.73, 2.98)

IL-6 antagonists

–

0.78 (0.42, 1.47)

Non-renal SOFA score

–

1.19 (1.04, 1.36)**

Baseline diuretics

–

1.06 (0.63, 1.78)

Max PEEP in first 48 h

–

1.03 (0.97, 1.09)

Vasopressor use

–

0.57 (0.33, 0.98)*

Delta FB between day 1 and 2 [mL/kg]

–

0.99 (0.97, 1.00)

 

Outcome: new KRT [OR (95% CI)] (n = 648)b

 

Unadjusted

Adjusted

Cumulative FB at 48 h

  

 < − 2% (n = 25)

0.26 (0.03, 1.99)

0.44 (0.06, 3.55)

 − 2% to 0% (n = 161)

0.79 (0.43, 1.44)

1.04 (0.53, 1.89)

 0% to + 2% (n = 269)

Reference

Reference

 + 2% to + 4% (n = 136)

1.70 (0.99, 2.91)

1.57 (0.87, 2.82)

 >  + 4% (n = 57)

3.94 (2.09, 7.45)***

4.16 (2.03, 8.51)***

Invasive ventilation

–

2.70 (1.10, 6.66)*

Remdesivir

–

0.61 (0.29, 1.26)

Steroids

–

3.22 (1.58, 6.54)**

IL-6 antagonists

–

0.84 (0.37, 1.89)

Non-renal SOFA score

–

0.98 (0.86, 1.12)

Baseline diuretics

–

1.14 (0.68, 1.94)

Max PEEP in first 48 h

–

1.00 (0.94, 1.07)

Vasopressor use

–

0.76 (0.45, 1.27)

Delta FB between day 1 and 2 [mL/kg]

–

1.01 (0.99, 1.03)

  1. AKI acute kidney injury, CI confidence interval, FB fluid balance, KRT kidney replacement therapy, IL-6 interleukin-6, OR odds ratio, PEEP positive end-expiratory pressure, SOFA Sequential Organ Failure Assessment
  2. a Adjusted for age, ethnicity, wave, gender, remdesivir, invasive ventilation, new steroids, IL-6 antagonists non-renal SOFA, vasopressors, diuretics, PEEP and change in fluid balance,
  3. bAdjusted for age, ethnicity, wave, gender, remdesivir, invasive ventilation, new steroids, IL-6 antagonists non-renal SOFA, vasopressors, diuretics, PEEP and change in fluid balance,
  4. *  p < 0.05 **  p < 0.01 ***  p < 0.001
  5. n = 352 excluded; n = 74 missing 48-h fluid balance data, n = 278 patients were diagnosed with AKI on day 0 and 1
  6. *  p < 0.05 **  p < 0.01 ***  p < 0.001
  7. n = 299 excluded; n = 74 missing 48-h fluid balance data, n = 50 patients received KRT on day 0 and 1