Özet:

Aim: The mortality and morbidity of COVID-19 disease are higher in patients with comorbidities. In this study, we staged patients with chronic renal failure hospitalized in the intensive care unit (ICU) and aimed to evaluate the process of the disease according to the stage of failure. Material and Method: The medical records of 249 patients followed in Ankara City Hospital MH3 ICU were reviewed retrospectively. The patients were divided into three stages according to their estimated glomerular filtration rate (e-GFR) value (stage 1: e-GFR≥90 ml/min/1.73 m², stage-2: e-GFR: 15-89 ml/min/1.73 m², stage- 3: e-GFR≤15 ml/min/1.73 m²). Data such as age, gender, comorbidity status, length of stay in the ICU, duration of mechanical ventilation, and mortality rate of the patients were recorded. Patients who were evaluated as stage-2 were also classified into 3 stages (stage-2a: e-GFR: 60-89 ml/min/1.73 m², stage-2b: e-GFR:30-59 ml/min/1.73 m², stage-2c: e-GFR: 15-29 ml/min/1.73 m²) and evaluated with the same parameters. Results: The mean age of all patients was 71 years. It was found that the intubation rate was higher (p=0.012) and the mortality rate was higher (p=0.003) in patients evaluated as stage-3. APACHE II and SOFA scores were higher than the other groups (p=<0.001, p=<0.01). In addition, IL-6, procalcitonin, D-dimer, and ferritin levels were also found to be significantly higher in these patients. Hemoglobin and thrombocyte levels were significantly lower than the other groups. When stage-2 patients were divided into subgroups, it was found that APACHE II and SOFA scores, mechanical ventilation rate, and mortality rate were higher in stage-2c than the other subgroups. While CRP, procalcitonin, and D-dimer values were significantly higher in this group, hemoglobin, thrombocyte, and lymphocyte values were found to be low. Conclusion: The mortality rate is high in COVID-19 patients with chronic kidney disease(CKD) in ICU. As the stage of the disease increases, the mechanical ventilation rate and mortality rate of the patients increase gradually. For this reason, it may be recommended to be more careful in terms of preventive measures in cases of CKD.

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