Renal Replacement Therapy for Acute Kidney Injury in COVID-19 Patients in Latin America

Abstract

The incidence of acute kidney injury (AKI) in hospitalized patients with COVID-19 is
\nbroad and ranges from 0.5 to 29% according to early reports from China and Italy [1, 2]. A
\nrecent multicenter retrospective cohort in New York showed a higher incidence (37%) and
\nmortality (35%). AKI was primarily seen in COVID-19 patients with respiratory failure; 89.7%
\nof patients who were on mechanical ventilation developed AKI as compared to just 21.7% of
\nnon-ventilated patients. Furthermore, 96.8% of patients who required renal replacement
\ntherapy (RRT) were on ventilators [3]. From these first reports, AKI emerges at the same time
\nas the acute respiratory distress syndrome, and the development of AKI is usually found in
\npatients who progress to phase 3 of the extra-pulmonary systemic hyper-inflammation
\nsyndrome [4]. Hirsch et al. [3] reported that up to 37.3% of AKI cases occurred within the first
\n24 h of hospital admission, and AKI frequently coincides with the development of the hyperinflammation
\nphase