MR-proAdrenomedullin as a predictor of renal replacement therapy in a cohort of critically ill patients with COVID-19. (4th July 2021)

• Record Type: Journal Article
• Authors: Roedl, Kevin; Jarczak, Dominik; Fischer, Marlene; Haddad, Munif; Boenisch, Olaf; de Heer, Geraldine; Burdelski, Christoph; Frings, Daniel; Sensen, Barbara; Karakas, Mahir; Kluge, Stefan; Nierhaus, Axel
• Is Part Of: Biomarkers. Volume 26:Number 5(2021)
• Page Start: 417
• Page End: 424
• Publication Date: 2021-07-04
• Subjects: COVID-19 -- multiple organ failure -- intensive care unit -- SARS-COV-2 -- acute kidney injury -- renal replacement therapy -- MR-proADM; Biochemical markers -- Periodicals; 610.28
• DOI: 10.1080/1354750X.2021.1905067
• Languages: English
• ISSNs: 1354-750X

Abstract

Abstract: Background: About 20% of ICU patients with COVID-19 require renal replacement therapy (RRT). Mid-regional pro-adrenomedullin (MR-proADM) might be used for risk assessment. This study investigates MR-proADM for RRT prediction in ICU patients with COVID-19. Methods: We analysed data of consecutive patients with COVID-19, requiring ICU admission at a university hospital in Germany between March and September 2020. Clinical characteristics, details on AKI, and RRT were assessed. MR-proADM was measured on admission. Results: 64 patients were included (49 (77%) males). Median age was 62.5y (54–73). 47 (73%) patients were ventilated and 50 (78%) needed vasopressors. 25 (39%) patients had severe ARDS, and 10 patients needed veno-venous extracorporeal membrane oxygenation. 29 (45%) patients required RRT; median time from admission to RRT start was 2 (1–9) days. MR-proADM on admission was higher in the RRT group (2.491 vs. 1.23 nmol/l; p = 0.002) and showed the highest correlation with renalSOFA. ROC curve analysis showed that MR-proADM predicts RRT with an AUC of 0.69 (95% CI: 0.543–0.828; p = 0.019). In multivariable logistic regression MR-proADM was an independent predictor (OR: 3.813, 95% CI 1.110–13.102, p <0.05) for RRT requirement. Conclusion: AKI requiring RRT is frequent in ICU patients with COVID-19. MR-proADM on admission was able to predict RRT requirement, which may be of interest for risk stratification and management.