Journal Article

Outcomes of acute kidney injury in patients receiving extracorporeal membrane oxygenation during the COVID-19 pandemic: a prospective, observational, and multi-center study

Bahbahani, Yousif, Mazroue, Ahmad, Abdalla, Emad, AlHelal, Bassam, Abdelmoteleb, Alaa, Mashal, Bassem, ElAbbadi, Mohamed, AlYousef, Anas, AlKandari, Abdulrahman, Alkandari, Omar, AlQallaf, Ahmed, AlRajab, Heba, ElHusseini, Ziad, Abdelrady, Ahmed, Abdelzaher, Ali, Abdellatif, Mohamed, AlSahow, Ali, Nessim, Gamal

2025

Overview

Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy in severe respiratory and/or cardiovascular failure. Acute kidney injury (AKI) is a frequent complication of ECMO that increases morbidity and mortality. We report the outcomes of patients with AKI who received ECMO. Clinical, management, and 30-d kidney and patient outcome data of adult inpatients with AKI who received ECMO in seven public hospitals in Kuwait from 1 January to 31 December 2021, were prospectively collected and analyzed. There were 3,744 AKI referrals to nephrology during study period, of which 121 received ECMO (3.2%). Patients with AKI on ECMO had a mean age of 56.3 years and a mean baseline eGFR of 81.6 mL/min. Preexisting chronic kidney disease was reported in 21.5% of patients, diabetes in 58.7%, and hypertension in 48%. COVID-19 infection contributed to AKI in 69% of the cases. AKI developed before ECMO initiation in 62% of cases. ECMO was veno-venous in 90% of cases. Dialysis was performed in 92% of cases, 97% of which was continuous modality. Mechanical ventilation was required in 94.2% of patients (all on inotropic support). At 30 d, 86.8% of the cohort died (91% of the deceased were on dialysis), 5% remained on dialysis, and only 3.3% recovered kidney function completely. AKI in patients receiving ECMO was associated with a high need for dialysis, and a high mortality rate. COVID-19 pandemic may have contributed to this outcome. ECMO modality, and whether AKI was pre or post ECMO did not affect the outcome.

• Publisher: Taylor & Francis Group
• Subject: Acute kidney injury / Acute Kidney Injury - epidemiology / Acute Kidney Injury - etiology / Acute Kidney Injury - mortality / Acute Kidney Injury - therapy / Adult / Aged / COVID-19 - complications / COVID-19 - epidemiology / dialysis / extracorporeal membrane oxygenation / Extracorporeal Membrane Oxygenation - adverse effects / Female / Humans / Kuwait / Kuwait - epidemiology / Male / Middle Aged / mortality / Prospective Studies / Renal Dialysis - statistics & numerical data / SARS-CoV-2 / Treatment Outcome