Observational studyJournal of nephrology2022
Acute kidney injury (AKI) in patients with Covid-19 infection is associated with ventilatory management with elevated positive end-expiratory pressure (PEEP).
Observational study in Journal of nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Global geographic and socioeconomic disparities in COVID-associated acute kidney injury: a systematic review and meta-analysis.Journal of global health · 2025Pooled it
- Article
- Impact of invasive mechanical ventilation support on renal function in critically ill patients.Revista da Escola de Enfermagem da U S P · 2026Observational
- Length of stay, duration of mechanical ventilation, mortality, and acute kidney injury in acute respiratory failure requiring endotracheal intubation.World journal of critical care medicine · 2025Article
- PEEP-AKI-COVID ICU: Effect of positive end-expiratory pressure on acute kidney injury development in patients with COVID-19-associated acute respiratory distress syndrome: an ancillary analysis of the COVID-ICU study.Journal of intensive care · 2025Article
- Positive end-expiratory pressure impact on cardiac output and cerebral hemodynamics in newborns.European journal of pediatrics · 2025Article
- Diuresis increase after positive end-expiratory pressure weaning during acute respiratory distress syndrome.Scientific reports · 2025Article
- Early Driving Pressure Is Associated with Major Adverse Kidney Events at 30 Days in ARDS Patients with SARS-CoV-2.Journal of clinical medicine · 2025Article
- Ventilation-induced acute kidney injury in acute respiratory failure: Do PEEP levels matter?Critical care (London, England) · 2025Review
- Clinical Characteristics and Prognostic Factors of Severe COVID-19.Infection and drug resistance · 2025Article
- Acute kidney injury in elderly patients receiving invasive mechanical ventilation: early versus late onset.European journal of medical research · 2024Observational
- Determination of positive end-expiratory pressure in COVID-19-related acute respiratory distress syndrome: A systematic review.European journal of anaesthesiology and intensive care · 2024Article
- Epidemiological study of hospital acquired acute kidney injury in critically ill and its effect on the survival.Scientific reports · 2024Observational
- Impact of positive end-expiratory pressure on renal resistive index in mechanical ventilated patients.Journal of clinical monitoring and computing · 2024Article
- Advancements in understanding the mechanisms of lung-kidney crosstalk.Intensive care medicine experimental · 2024Review
- Perfusion deficits may underlie lung and kidney injury in severe COVID-19 disease: insights from a multicenter international cohort study.Journal of anesthesia, analgesia and critical care · 2024Review
- Controlled Mechanical Ventilation in Critically Ill Patients and the Potential Role of Venous Bagging in Acute Kidney Injury.Journal of clinical medicine · 2024Article
- COVID-19 and Kidney: The Importance of Follow-Up and Long-Term Screening.Life (Basel, Switzerland) · 2023Review
- Kidney Injury in Critically Ill Patients with COVID-19 - From Pathophysiological Mechanisms to a Personalized Therapeutic Model.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2023Review
- Relationship between positive end-expiratory pressure levels, central venous pressure, systemic inflammation and acute renal failure in critically ill ventilated COVID-19 patients: a monocenter retrospective study in France.Acute and critical care · 2023Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute kidney injury (AKI) in Covid-19 patients admitted to the intensive care unit (ICU) is common, and its severity may be associated with unfavorable outcomes. Severe Covid-19 fulfills the diagnostic criteria for acute respiratory distress syndrome (ARDS); however, it is unclear whether there is any relationship between ventilatory management and AKI development in Covid-19 ICU patients. PURPOSE: To describe the clinical course and outcomes of Covid-19 ICU patients, focusing on ventilatory management and factors associated with AKI development.
methodsSingle-center, retrospective observational study, which assessed AKI incidence in Covid-19 ICU patients divided by positive end expiratory pressure (PEEP) tertiles, with median levels of 9.6 (low), 12.0 (medium), and 14.7 cmH
resultsOverall mortality was 51.5%. AKI (KDIGO stage 2 or 3) occurred in 38% of 101 patients. Among the AKI patients, 19 (53%) required continuous renal replacement therapy (CRRT). In AKI patients, mortality was significantly higher versus non-AKI (81% vs. 33%, p < 0.0001). The incidence of AKI in low-, medium-, or high-PEEP patients were 16%, 38%, and 59%, respectively (p = 0.002). In a multivariate analysis, high-PEEP patients showed a higher risk of developing AKI than low-PEEP patients (OR = 4.96 [1.1-21.9] 95% CI p < 0.05). ICU mortality rate was higher in high-PEEP patients, compared to medium-PEEP or low-PEEP patients (69% vs. 44% and 42%, respectively; p = 0.057).
conclusionThe use of high PEEP in Covid-19 ICU patients is associated with a fivefold higher risk of AKI, leading to higher mortality. The cause and effect relationship needs further analysis.
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