JENQ-WEN HUANGKUAN-YU CHENHUNG-BIN TSAIVIN-CENT WUYa-Fei YangMING-SHIOU WUTZONG-SHINN CHUKWAN-DUN WU2020-12-242020-12-242005-120929-6646https://www.scopus.com/inward/record.uri?eid=2-s2.0-33745288154&partnerID=40&md5=35050706e50c83bde9186b3be4bd2f2ehttps://scholars.lib.ntu.edu.tw/handle/123456789/531861BACKGROUND AND PURPOSE: Severe acute respiratory syndrome (SARS) is caused by a new coronavirus, and results in respiratory failure. Acute renal failure (ARF) may also occur and/or complicate the disease course, however, its incidence, causes and impact in SARS patients are not known. METHODS: ARF patients were identified from a total of 78 (33 men and 45 women) probable SARS cases admitted to a single hospital. The clinical features of patients with ARF were characterized, and the etiologies analyzed. RESULTS: Patients were assigned to ARF (n = 13; 17%) and non-ARF groups (n = 65). Patients with ARF were older than their non-ARF counterparts. ARF developed 7.2 +/- 4.3 days after admission. The incidence of ARF was higher in males (77% vs 35%; p < 0.05). Comorbidities of diabetes and heart failure were more common in patients who developed ARF (38% vs 6%, p < 0.01 and 38% vs 2%, p < 0.001, respectively) and the incidence of respiratory failure (85% vs 26%, p < 0.001) and mortality (77% vs 8%, p < 0.001) were also higher. Multiple organ system failure usually accompanied ARF. Hypotension (77%) caused by nosocomial infections, gastrointestinal bleeding, or SARS per se, and rhabdomyolysis (43%) was associated with ARF in addition to pre-renal factors. Five patients in the ARF group and 1 female patient with end-stage renal failure underwent renal replacement therapy during hospitalization; however, both eventually died. Of the 16 medical staff performing renal replacement therapy, none was subsequently infected with SARS coronavirus. CONCLUSIONS: Development of ARF during the disease course in SARS patients is associated with catastrophic outcome. The cause of ARF in SARS patients is often associated with pre-renal factors, hypotension, rhabdomyolysis, and previous comorbidities including diabetes and old age. Universal precautions to prevent viral transmission are mandatory for medical staff performing renal replacement therapy.[SDGs]SDG3acute kidney failure; aged; article; chi square distribution; female; human; incidence; male; middle aged; multiple organ failure; renal replacement therapy; risk factor; severe acute respiratory syndrome; survival; Taiwan; Aged; Chi-Square Distribution; Female; Humans; Incidence; Kidney Failure, Acute; Male; Middle Aged; Multiple Organ Failure; Renal Replacement Therapy; Risk Factors; Severe Acute Respiratory Syndrome; Survival Analysis; Taiwanjournal article166074452-s2.0-33745288154