Banca de DEFESA: FLAVIA LARA BARCELOS

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : FLAVIA LARA BARCELOS
DATE: 30/09/2022
TIME: 14:00
LOCAL: Plataforma Teams
TITLE:

Evaluation of Acute Kidney Injury in patients with severe SARS-CoV2 admitted at University Hospital of Brasília

KEY WORDS:

COVID19, acute kidney injury, apolipoprotein L1, podocyte

PAGES: 50
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Introduction: The COVID19 pandemic increased the number of cases of acute renal failure (ARI) and the need for renal replacement therapy (RRT). The physiopathogenic mechanisms, risk factors and their long-term evolution are not fully understood. Methodology: A prospective cohort of 102 inpatients with severe or critical illness due to COVID19 infection was carried out during the period from May 1, 2020 to September 30, 2020 at Hospital Universitário de Brasília (HUB). Follow-up was performed for 01 year after hospital discharge. The primary outcomes were the assessment of incidence of ARI during hospitalization and assessment of mortality on the 28th day of hospitalization, and after 01 year. The secondary outcomes were the assessment of risk factors related to AKI and the follow-up of 06 patients who underwent renal biopsy for renal dysfunction related to COVID19 from June 2020 to July 2021, with a genetic study for high-risk variants (VAR) of apolipoprotein L1 (APOL1). Data collection was carried out through research in electronic medical records. Patients were divided into groups according to the occurrence of ARI and the need for KRT to assess risk factors. Statistical analysis was performed by medians and interquartiles intervals (25%-75%) for continuous variables and number and percentages for categorical variables. Multivariate logistic regression models were used to identify independent risk factors.

Results: The overall mortality at 28 days, at hospital outcome and at 01 year were, respectively, 63% (n=64), 67% (n=68) and 75% (n=76). Analysis of survival at 01 year revealed a mortality of 87.2% (n=68) in the ARI group versus 33.3% (n=8) in the group without ARI (Harzard Ratio 2.90 [1.30-6.45], p = 0.009). When considering the group that underwent RRT, mortality was 89.5% (n=51) against 55.6% in the group without KRT (Harzard Ratio 1.92 [1.14-3.23], p=0.015). Admission creatinine and mechanical ventilation were correlated as independent risk factors for AKI. The most prevalent morphological finding in the sample of patients undergoing renal biopsy was podocytopathy. The genetic study identified a high prevalence of VAR APOL1 (4/6). Conclusion: Acute renal failure and the need for RRT were associated with high mortality in our sample. In addition, a high prevalence of HRG was identified among the biopsied patients. Outpatient follow-up of these patients revealed favorable long-term outcomesPalavras chaves em português:

BANKING MEMBERS:
Externo à Instituição - ISTÊNIO JOSÉ FERNANDES PASCOAL - CBND
Externo ao Programa - 747.051.488-00 - JOEL PAULO RUSSOMANO VEIGA - USP
Interno - 141.787.884-34 - LEOPOLDO LUIZ DOS SANTOS NETO - UnB
Interna - 1189371 - VERONICA MOREIRA AMADO