tetano
Editor, Senior Moderator
Clin Exp Nephrol
. 2022 Jun 3.
doi: 10.1007/s10157-022-02240-x. Online ahead of print.
Chronic kidney disease and clinical outcomes in patients with COVID-19 in Japan
Ryosuke Sato[SUP] 1 [/SUP], Yasushi Matsuzawa[SUP] 2 [/SUP], Hisao Ogawa[SUP] 3 [/SUP], Kazuo Kimura[SUP] 1 [/SUP], Nobuo Tsuboi[SUP] 4 [/SUP], Takashi Yokoo[SUP] 4 [/SUP], Hirokazu Okada[SUP] 5 [/SUP], Masaaki Konishi[SUP] 6 [/SUP], Jin Kirigaya[SUP] 7 [/SUP], Kazuki Fukui[SUP] 8 [/SUP], Kengo Tsukahara[SUP] 9 [/SUP], Hiroyuki Shimizu[SUP] 10 [/SUP], Keisuke Iwabuchi[SUP] 11 [/SUP], Yu Yamada[SUP] 12 [/SUP], Kenichiro Saka[SUP] 13 [/SUP], Ichiro Takeuchi[SUP] 7 [/SUP], Naoki Kashihara[SUP] 14 [/SUP], Kouichi Tamura[SUP] 6 [/SUP]
Affiliations
Abstract
Background: Identifying predictive factors for coronavirus disease 2019 (COVID-19) is crucial for risk stratification and intervention. Kidney dysfunction contributes to the severity of various infectious diseases. However, the association between on-admission kidney dysfunction and the clinical outcome in COVID-19 patients is unclear.
Methods: This study was a multicenter retrospective observational cohort study of COVID-19 patients, diagnosed by polymerase chain reaction. We retrospectively analyzed 500 COVID-19 patients (mean age: 51 ± 19 years) admitted to eight hospitals in Japan. Kidney dysfunction was defined as a reduced estimated glomerular filtration rate (< 60 mL/min/1.73 m[SUP]2[/SUP]) or proteinuria (≥ 1 + dipstick proteinuria) on admission. The primary composite outcome included in-hospital death, extracorporeal membrane oxygenation, mechanical ventilation (invasive and noninvasive methods), and intensive care unit (ICU) admission.
Results: Overall, 171 (34.2%) patients presented with on-admission kidney dysfunction, and the primary composite outcome was observed in 60 (12.0%) patients. Patients with kidney dysfunction showed higher rates of in-hospital death (12.3 vs. 1.2%), mechanical ventilation (13.5 vs. 4.0%), and ICU admission (18.1 vs. 5.2%) than those without it. Categorical and multivariate regression analyses revealed that kidney dysfunction was substantially associated with the primary composite outcome. Thus, on-admission kidney dysfunction was common in COVID-19 patients. Furthermore, it correlated significantly and positively with COVID-19 severity and mortality.
Conclusions: On-admission kidney dysfunction was associated with disease severity and poor short-term prognosis in patients with COVID-19. Thus, on-admission kidney dysfunction has the potential to stratify risks in COVID-19 patients.
Keywords: COVID-19; Clinical outcome; Kidney dysfunction.
. 2022 Jun 3.
doi: 10.1007/s10157-022-02240-x. Online ahead of print.
Chronic kidney disease and clinical outcomes in patients with COVID-19 in Japan
Ryosuke Sato[SUP] 1 [/SUP], Yasushi Matsuzawa[SUP] 2 [/SUP], Hisao Ogawa[SUP] 3 [/SUP], Kazuo Kimura[SUP] 1 [/SUP], Nobuo Tsuboi[SUP] 4 [/SUP], Takashi Yokoo[SUP] 4 [/SUP], Hirokazu Okada[SUP] 5 [/SUP], Masaaki Konishi[SUP] 6 [/SUP], Jin Kirigaya[SUP] 7 [/SUP], Kazuki Fukui[SUP] 8 [/SUP], Kengo Tsukahara[SUP] 9 [/SUP], Hiroyuki Shimizu[SUP] 10 [/SUP], Keisuke Iwabuchi[SUP] 11 [/SUP], Yu Yamada[SUP] 12 [/SUP], Kenichiro Saka[SUP] 13 [/SUP], Ichiro Takeuchi[SUP] 7 [/SUP], Naoki Kashihara[SUP] 14 [/SUP], Kouichi Tamura[SUP] 6 [/SUP]
Affiliations
- PMID: 35657437
- DOI: 10.1007/s10157-022-02240-x
Abstract
Background: Identifying predictive factors for coronavirus disease 2019 (COVID-19) is crucial for risk stratification and intervention. Kidney dysfunction contributes to the severity of various infectious diseases. However, the association between on-admission kidney dysfunction and the clinical outcome in COVID-19 patients is unclear.
Methods: This study was a multicenter retrospective observational cohort study of COVID-19 patients, diagnosed by polymerase chain reaction. We retrospectively analyzed 500 COVID-19 patients (mean age: 51 ± 19 years) admitted to eight hospitals in Japan. Kidney dysfunction was defined as a reduced estimated glomerular filtration rate (< 60 mL/min/1.73 m[SUP]2[/SUP]) or proteinuria (≥ 1 + dipstick proteinuria) on admission. The primary composite outcome included in-hospital death, extracorporeal membrane oxygenation, mechanical ventilation (invasive and noninvasive methods), and intensive care unit (ICU) admission.
Results: Overall, 171 (34.2%) patients presented with on-admission kidney dysfunction, and the primary composite outcome was observed in 60 (12.0%) patients. Patients with kidney dysfunction showed higher rates of in-hospital death (12.3 vs. 1.2%), mechanical ventilation (13.5 vs. 4.0%), and ICU admission (18.1 vs. 5.2%) than those without it. Categorical and multivariate regression analyses revealed that kidney dysfunction was substantially associated with the primary composite outcome. Thus, on-admission kidney dysfunction was common in COVID-19 patients. Furthermore, it correlated significantly and positively with COVID-19 severity and mortality.
Conclusions: On-admission kidney dysfunction was associated with disease severity and poor short-term prognosis in patients with COVID-19. Thus, on-admission kidney dysfunction has the potential to stratify risks in COVID-19 patients.
Keywords: COVID-19; Clinical outcome; Kidney dysfunction.