Acute Kidney Injury as a Predictor of Mortality in Patients with COVID-19 (original) (raw)
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Investigation of acute kidney injury and related risk factors in patients with COVID-19
Journal of Renal Injury Prevention
Introduction: The 2019 recent coronavirus disease (COVID- 19) is a novel pandemic disease in the world. The main organ involved in this viral sepsis is the respiratory system. Objectives: Regarding the expression of angiotensin-converting enzyme (ACE) receptors as entering route for virus’ particles into cells, the kidney organ is another important target in this catastrophic sepsis. There is little data about renal complications and related risk factors in victims. Patients and Methods: All patients with COVID-19 admitted to a referral and tertiary center (Shohada hospital, Khorramabad, Iran) were included in the study. The research was performed from February 20 to April 19, 2020. Diagnosis of patients was confirmed by COVID-19 upper respiratory sampling using real-time PCR. Patients’ demographic data, clinical and laboratory variables were included in pre-designed questionnaires according to the considered factors; then all collected data was entered into SPSS-26 software and sta...
Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19
Journal of Clinical Medicine, 2021
Background: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients is variable and has been associated with worse prognosis. A significant number of patients develop persistent kidney damage defined as Acute Kidney Disease (AKD). There is a lack of evidence on the real impact of AKD on COVID-19 patients. We aim to identify risk factors for the development of AKD and its impact on mortality in COVID-19 patients. Methods: Retrospective analysis of COVID-19 patients with AKI admitted at the Centro Hospitalar Universitário Lisboa Norte between March and August of 2020. The Kidney Disease Improving Global Outcomes (KDIGO) classification was used to define AKI. AKD was defined by presenting at least KDIGO Stage 1 criteria for >7 days after an AKI initiating event. Results: In 339 COVID-19 patients with AKI, 25.7% patients developed AKD (n = 87). The mean age was 71.7 ± 17.0 years, baseline SCr was 1.03 ± 0.44 mg/dL, and the majority of patients were classified as KDIGO st...
Risk Factors for Acute Kidney Injury in COVID-19 Patients: A Systematic Review
2021
BACKGROUND: Acute kidney injury (AKI) in coronavirus disease-19 (COVID-19) has high incidence and mortality. Risk factors for AKI in COVID-19 patients are not well explored. This systematic review provides a combination of available evidence regarding risk factors of AKI in COVID-19 patients. METHODS: A systematic research was performed in Medline, Cochrane Central Register of Controlled Trials, and ScienceDirect journal databases from 2019 to August 2020. The study selection process was plotted using a Preferred Reporting Items for Systematic Review and Meta-Analyses flow diagram. RESULTS: Out of 553 studies found, four full-text studies met the inclusion criteria and were included in qualitative analysis. There are 2205 COVID-19 patients with AKI (36.44%) from 6051 COVID-19 patients. Age was a risk factors for AKI in two studies (odds ratio [OR] 1.03 [p < 0.001], OR 1.03 [p < 0.007]). Critical condition of patient is risk factors for AKI (OR 8.155 [p = 0.006]). Hirsch et al....
Acute kidney injury in hospitalized patients due to COVID-19
2021
The incidence of acute kidney injury (AKI) in hospitalized patients with coronavirus disease 2019 (COVID-19) is variable, being associated with worse outcomes. The objectives of the study were to evaluate the incidence, risk factors and impact of AKI in subjects hospitalized for COVID-19 in two third- level hospitals in Cordoba, Argentina. A retrospective cohort study was conducted. 448 adults who were consecutively hospitalized for COVID-19 between March and the end of October 2020 at Hospital Privado Universitario de Cordoba and Hospital Raul Angel Ferreyra were included. The incidence of AKI was 19% (n=85). 50.6% presented AKI stage 1 (n=43), 20% stage 2 (n=17) and 29.4% stage 3 (n=25, of which 18 required renal replacement therapy). In the multivariate analysis, the variables that were independently associated with AKI were: age (adjusted Odd ratio -aOR- =1.30, 95%CI=1.04-1.63, p=0.022), history of chronic kidney disease (aOR=9.92, 95%CI=4.52-21.77, p<0.001), blood neutrophil...
Frontiers in Medicine, 2020
Background: The kidney is a target organ that could be infected by SARS-CoV-2, and acute kidney injury (AKI) was associated with a higher risk of COVID-19 patients' in-hospital death. However, no published works discussed about the risk factors of COVID-19 related AKI. Methods: We conducted a retrospective cohort study, recruiting COVID-19 inpatients from the Sino-French branch of Tongji Hospital. Demographic, clinical, treatment, and laboratory data were collected and compared. We used univariable and multivariable logistic regression methods to identify the risk factors of COVID-19-related AKI. Results: Of the 116 patients in our study, 12 (10.3%) were recognized as AKI, including 5 (4.3%) in-hospital AKI. Multivariable regression showed increasing odds of COVID-19-related AKI associated with COVID-19 clinical classification (OR = 8.155, 95% CI = 1.848-35.983, ref = non-critical, p = 0.06), procalcitonin more than 0.1 ng/mL (OR = 4.822, 95% CI = 1.095-21.228, p = 0.037), and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 (OR = 13.451, 95% CI = 1.617-111.891, p = 0.016). Conclusions: COVID-19-related AKI was likely to be related to multiorgan failure rather than the kidney tropism of SARS-CoV-2. The potential risk factors of COVID-19 clinical classification, procalcitonin more than 0.1 ng/mL, and eGFR <60 mL/min/1.73 m 2 could help clinicians to identify patients with kidney injury at an early stage.
Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury
Journal of Clinical Medicine, 2020
The outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severity. Medical data of hospitalized COVID-19 patients in two university-based hospitals during an outbreak in Daegu, South Korea, were retrospectively analyzed. AKI and its severity were defined according to the Acute Kidney Injury Network. Of the 164 hospitalized patients with COVID-19, 30 patients (18.3%) had AKI; 14, 4, and 12 patients had stage 1, 2, and 3, respectively. The median age was significantly higher in AKI patients than in non-AKI patients (75.5 vs. 67.0 years, p = 0.005). There were 17 deaths (56.7%) among AKI patients; 4 (28.6%), 1 (25.0%), and 12 (100.0%), respectively. In-hospital mortality was higher in AKI patients than in non-AKI patients (56.7% vs. 20.8%, p < 0.001)...
The Frequency and Risk Factors for Acute Kidney Injury in patients with COVID-19
Pakistan Journal of Medical Sciences, 2022
Objective: To determine the frequency of Acute Kidney Injury (AKI) and its underlying risk factors in patients with Coronavirus Disease (COVID-19). Methods: This retrospective study was conducted by reviewing the medical records of patients admitted in Covid-19 Intensive Care Unit (ICU) of Farooq Hospital, West Wood Branch, Lahore during the period from 1st April, 2020 to 30th June, 2020. COVID-19 was diagnosed on basis of Real Time Polymerase Chain Reaction (RT-PCR) through nasal swab. Demographic, clinical and laboratory data were collected at the time of admission in the hospital. AKI was diagnosed on basis of ≥ 0.3 mg/dl increase in serum Creatinine (sCr) from baseline during the hospital stay. The outcome of study was AKI. Results: One hundred and seventy-six patients who fulfilled the inclusion criteria were recruited of which most were males (78.4%). The mean age was 51.26 ± 15.20 years and the frequency of AKI was 51.1%. The risk factors for AKI were increasing age (OR=2.10,...
Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact
F1000Research, 2024
Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mainly affects the respiratory tract, but different organs may be involved including the kidney. Data on acute kidney injury (AKI) in critical forms of coronavirus disease 2019 (COVID-19) are scarce. We aimed to assess the incidence, risk factors and prognostic impact of AKI complicating critical forms of COVID-19. Methods
COVID-19 and acute kidney injury presentation; stages and prognosis
Journal of Preventive Epidemiology
Introduction: Coronavirus disease 2019 (COVID-19) can present with acute kidney injury (AKI). Although the rate of AKI among these patients is not high, their outcome could be much worse than the other patients. Serum creatinine rise along with other laboratory findings may help as a clinical predictor of COVID-19 disease prognosis. Objectives: We aimed to evaluate the incidence and possible predictors of AKI occurrence and its outcome during the COVID-19 pandemic. Patients and Methods: In a retrospective observational study of 946 hospital-admitted patients with confirmed COVID-19 between March 20, 2020 and May 9, 2020, we described AKI incidence and its stages along with their association with demographic data, comorbidities, habitual and past-medical history, and laboratory findings using STATA version 14. Results: The mean age of participants was 55.6 (±18.7) years of which 60.4% were male. The most and least frequent underlying diseases were hypertension and chronic liver disea...
Cureus, 2021
Background and objective The coronavirus disease 2019 (COVID-19) pandemic has become a global healthcare emergency. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has a wide range of clinical manifestations ranging from subclinical infection to multi-organ failure. In addition to the respiratory system, COVID-19 also adversely affects the kidneys. In this study, we aimed to measure the prevalence of acute kidney injury (AKI) in COVID-19 and its association with the disease severity and mortality in COVID-19 patients. Materials and methods We conducted our study by following the Preferred Reporting Items for Systematic Review and Metaanalyses (PRISMA) guidelines. A comprehensive literature search using four databases (PubMed, EMBASE, Google Scholar, and clinicaltrial.gov) was performed. Our initial search returned 2,771 articles. After excluding review articles, duplicates, and non-relevant studies, we included 20 articles that reported an association between COVID-19 and AKI. We subsequently performed a random effect analysis to find the pooled prevalence, pooled odds ratio (OR) estimates, and 95% confidence intervals for severe COVID-19 and mortality outcomes in AKI using Cochrane RevMan (version 5.4) and R programming language (version 4.16-2). Results A total of 14,415 patients from various countries were included. Among the 20 cohorts, the median age was 55.8 ±8.39 years (range: 43-72 years), and 43.78% of the subjects were female. Out of a total of 14,415 patients, 3,820 developed AKI with a pooled prevalence of 11% (95% CI: 0.07-0.15; p<0.01; I 2 =98%). AKI was found to have a significant association with severe COVID-19 disease, with a pooled OR of 8.45 (95% CI: 5.56-12.56; p<0.00001; I 2 =0%). AKI was associated with significantly higher mortality in patients with COVID-19 with an OR of 13.52 (95% CI: 5.43-33.67; p<0.00001; I 2 =88%). Conclusion AKI manifests as a common COVID-19 complication, and COVID-19 patients with AKI generally have poor outcomes in terms of disease severity and mortality.