#4274 CLINICAL FEATURES AND OUTCOMES OF COVID-19-ASSOCIATED ACUTE KIDNEY INJURY REQUIRING DIALYSIS: EXPERIENCE FROM THE FIRST COVID-19 HOSPITAL IN SERBIA

Abstract Background and Aims The new coronavirus disease (COVID-19) pandemic faced the healthcare sector worldwide with an unprecedented challenge. Although respiratory failure is main feature of disease, renal involvement also common, particularly in critically ill patients, often requires urgent dialysis treatment. This study aimed to analyse clinical features risk factors for poor outcomes patients COVID-19-associated acute kidney injury (AKI) requiring dialysis. Method All 98 included this retrospective observational were treated first hospital Serbia transformed exclusively admit COVID-19 at onset epidemic. Data collected from charts patient histories period between March 19, 2020, 2022, analysed SPSS software, version 22 (IBM Corporation, New York, USA). Results Out 6,540 non-pregnant adult hospitalized (1,955 intensive care unit) observed period, (85.7% male, age range 25-89 years) developed dialysis-requiring AKI. A total 312 hemodialyses (HD) treatments performed (3.18±2.39, 1-12, per patient), mostly intermittent HD patients) pertaining technical resources. majority (90.8%) had least one comorbidity – hypertension (38.8%), diabetes (28.6%), cardiovascular (11.2%), cerebrovascular (3.1%), chronic (7.1%), malignancy (6.1%), or autoimmune (1.0%). Most required mechanical ventilation. Only 8 (8.2%) vaccinated. Nearly half (49.0%) bilateral pneumonia 2.0% ARDS presentation, average CT severity score 14.05±6.72 (range 1-25) presentation. Time AKI presentation was 8.96±5.14 days 2-25). overall mortality rate 91.8%. Surviving significantly more procedures (5.00±2.39 vs 3.02±2.34; P = .024) lower procalcitonin level (1.89±0.16 ng/mL 6.14±9.57 ng/mL; .015) Fatal outcome common individuals ventilation (p<0.001). Other demographic (age, sex, smoking habit), (comorbidities, vaccination status, radiographic finding, score, time onset, type dialysis) laboratory parameters (WBC, neutrophil/lymphocyte ratio, CK, LDH, urea, creatinine, CRP, IL-6, D-dimer, ferritin) not associated adverse outcome. Multiple logistic regression showed that fewer a higher (OR 0.77, 95% CI 0.60-0.99, .039). Conclusion Patients who develop setting have extremely high rate. Higher procalcitonin, need number are fatal population.