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Acute Kidney Injury (AKI) is characterized by the sudden loss of renal function, diagnosed by an increase in creatinine levels and a reduction in urine output, persisting for up to 7 days. AKI is highly prevalent in intensive care units, predominantly affecting elderly patients with multiple organ failure, leading to high mortality rates and elevated costs [1]. Around 5% of ICU-admitted patients receive renal replacement therapy (RRT), and in-hospital mortality tends to exceed 50%. Individuals discharged after an episode of AKI with RRT face a greater risk of long-term dialysis dependence and mortality compared to those without AKI [2, 3].
An extensive retrospective cohort study, published in Critical Care in 2012 and conducted in Finland, revealed that over a nearly two-year period, spanning from January 2007 to December 2008, 6.8% of patients admitted to the ICU received Renal Replacement Therapy (RRT) due to acute kidney injury. This corresponds to a yearly population-based incidence of 19.2 per 100,000 for adults aged 15 years and above. Globally, the incidence of RRT-treated AKI varies, ranging from 8 to 30 per 100,000 [6].
A study conducted at a tertiary referral center in Hong Kong observed that out of a total of 1652 patients admitted to the intensive care unit over a 12-month period, 131 (8%) underwent continuous renal replacement therapy [4].In addition, a prospective observational study, conducted in 54 centers across 23 countries, showed that hospital mortality associated with RRT remained high at 64%. [5]
In addition, it is important to draw attention to the mortality of patients with Acute Kidney Injury (AKI) undergoing RRT. A prospective observational study, conducted in 54 centers across 23 countries, showed that hospital mortality associated with RRT remained high at 64% [6]. e um estudo observacional publicado na Advances in Clinical and Experimental Medicine em 2018 mostrou que the overall mortality of the critically ill AKI patients requiring RRT was significantly higher than in the overall ICU population (69.4% vs 41.0%; p < 0.01) [7].
This present study aims to analyze the number of dialysis sessions in ICU patients at a tertiary referral hospital in Londrina, PR, Brazil, showing the change in the pattern of numbers before and after the COVID-19 pandemic and how this disease has altered the numbers of patients undergoing renal replacement therapy.
Retrospectively analyse data on the number of dialysis procedures performed on Intensive Care Unit (ICU) patients at a prominent tertiary hospital in Brazil, collected between 2020 and 2023.
Our data indicates a significant increase in the number of patients undergoing hemodialysis renal replacement therapy, with an 8.04-fold rise compared to January 2020. This trend persisted from the first half of 2020 to September 2023, with average dialysis patient numbers climbing from 56.5 in 2020 to 286.5 in 2023. Monthly dialysis procedures per patient also surged, with a 289% increase from early 2020 to 2023. Notably, the percentage of dialysis patients testing positive for SARS-COV2 rose from 50% in the second half of 2020 to an average of 60% in 2021, emphasizing the impact of COVID-19 on this population.
There was a substantial and consistent increase in hemodialysis patients from the first half to 2020 to September 2023, underscoring the influence of the COVID-19 pandemic.