The effect of frailty on the development of acute kidney injury in critically-ill geriatric patients with COVID-19

Authors: MURAT KÜÇÜK, BİŞAR ERGÜN, MEHMET NURİ YAKAR, ÖZER URAL ÇAKICI, ERDEM YAKA, BİLGİN CÖMERT, ALİ NECATİ GÖKMEN, BEGÜM ERGAN

Abstract: Background/aim: Acute kidney injury is strongly associated with mortality in critically ill patients with coronavirus disease 2019 (COVID-19); however, age-related risk factors for acute kidney injury are not clear yet. In this study, it was aimed to evaluate the effects of clinical factors on acute kidney injury development in an elderly COVID-19 patients. Materials and methods: Critically ill patients (?65years) with COVID-19 admitted to the intensive care unit were included in the study. Primary outcome of the study was the rate of acute kidney injury, and secondary outcome was to define the effect of frailty and other risk factors on acute kidney injury development and mortality. Results: A total of 132 patients (median age 76 years, 68.2% male) were assessed. Patients were divided into two groups as follows: acute kidney injury (n = 84) and nonacute kidney injury (n = 48). Frailty incidence (48.8% vs. 8.3%, p < 0.01) was higher in the acute kidney injury group. In multivariate analysis, frailty (OR, 3.32, 95% CI, 1.67?6.56), the use of vasopressors (OR, 3.06 95% CI, 1.16?8.08), and the increase in respiratory support therapy (OR, 2.60, 95% CI, 1.01?6.6) were determined to be independent risk factors for acute kidney injury development. The mortality rate was found to be 97.6% in patients with acute kidney injury. Conclusion: Frailty is a risk factor for acute kidney injury in geriatric patients with severe COVID-19. The evaluation of geriatric patients based on a frailty scale before intensive care unit admission may improve outcomes.

Keywords: Frailty, COVID-19, acute kidney injury, intensive care

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