tetano
Editor, Senior Moderator
Clin J Am Soc Nephrol
. 2020 Sep 22;CJN.04650420.
doi: 10.2215/CJN.04650420. Online ahead of print.
The Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Adult Patients with Coronavirus Disease 2019
Yichun Cheng[SUP] 1 [/SUP], Ran Luo[SUP] 1 [/SUP], Xu Wang[SUP] 2 [/SUP], Kun Wang[SUP] 1 [/SUP], Nanhui Zhang[SUP] 1 [/SUP], Meng Zhang[SUP] 1 [/SUP], Zhixiang Wang[SUP] 1 [/SUP], Lei Dong[SUP] 1 [/SUP], Junhua Li[SUP] 1 [/SUP], Rui Zeng[SUP] 1 [/SUP], Ying Yao[SUP] 1 [/SUP], Shuwang Ge[SUP] 3 [/SUP], Gang Xu[SUP] 3 [/SUP]
Affiliations
Abstract
Background and objectives: Since December 2019, coronavirus disease 2019 (COVID-19) outbreak occurred and has rapidly spread worldwide. However, little information is available about the AKI in COVID-19. We aimed to evaluate the incidence, risk factors, and prognosis of AKI in adult patients with COVID-19.
Design, setting, participants, & measurements: This was a retrospective cohort study of 1392 patients with COVID-19 admitted to a tertiary teaching hospital. Clinical characteristics and laboratory data were extracted from electronic hospitalization and laboratory databases. AKI was defined and staged according to the 2012 Kidney Disease: Improving Global Outcomes criteria. Risk factors for AKI and the association of AKI with in-hospital mortality were assessed.
Results: A total of 7% (99 of 1392) of patients developed AKI during hospitalization, 40% (40 of 99) of which occurred within 1 week of admission. Factors associated with a higher risk of AKI include severe disease (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.37 to 3.67), higher baseline serum creatinine (OR, 2.19; 95% CI, 1.17 to 4.11), lymphopenia (OR, 1.99; 95% CI, 1.12 to 3.53), and elevated D-dimer level (OR, 2.68; 95% CI, 1.07 to 6.70). The in-hospital mortality in patients with AKI stage 1, stage 2, and stage 3 was 62%, 77%, and 80%, respectively. AKI was associated with in-hospital mortality even after adjustment for confounders (OR, 5.12; 95% CI, 2.70 to 9.72).
Conclusions: AKI is uncommon but carries high in-hospital mortality in patients with COVID-19.
Keywords: COVID-19; acute kidney injury; mortality; prognosis; risk factors.
. 2020 Sep 22;CJN.04650420.
doi: 10.2215/CJN.04650420. Online ahead of print.
The Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Adult Patients with Coronavirus Disease 2019
Yichun Cheng[SUP] 1 [/SUP], Ran Luo[SUP] 1 [/SUP], Xu Wang[SUP] 2 [/SUP], Kun Wang[SUP] 1 [/SUP], Nanhui Zhang[SUP] 1 [/SUP], Meng Zhang[SUP] 1 [/SUP], Zhixiang Wang[SUP] 1 [/SUP], Lei Dong[SUP] 1 [/SUP], Junhua Li[SUP] 1 [/SUP], Rui Zeng[SUP] 1 [/SUP], Ying Yao[SUP] 1 [/SUP], Shuwang Ge[SUP] 3 [/SUP], Gang Xu[SUP] 3 [/SUP]
Affiliations
- PMID: 32963018
- DOI: 10.2215/CJN.04650420
Abstract
Background and objectives: Since December 2019, coronavirus disease 2019 (COVID-19) outbreak occurred and has rapidly spread worldwide. However, little information is available about the AKI in COVID-19. We aimed to evaluate the incidence, risk factors, and prognosis of AKI in adult patients with COVID-19.
Design, setting, participants, & measurements: This was a retrospective cohort study of 1392 patients with COVID-19 admitted to a tertiary teaching hospital. Clinical characteristics and laboratory data were extracted from electronic hospitalization and laboratory databases. AKI was defined and staged according to the 2012 Kidney Disease: Improving Global Outcomes criteria. Risk factors for AKI and the association of AKI with in-hospital mortality were assessed.
Results: A total of 7% (99 of 1392) of patients developed AKI during hospitalization, 40% (40 of 99) of which occurred within 1 week of admission. Factors associated with a higher risk of AKI include severe disease (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.37 to 3.67), higher baseline serum creatinine (OR, 2.19; 95% CI, 1.17 to 4.11), lymphopenia (OR, 1.99; 95% CI, 1.12 to 3.53), and elevated D-dimer level (OR, 2.68; 95% CI, 1.07 to 6.70). The in-hospital mortality in patients with AKI stage 1, stage 2, and stage 3 was 62%, 77%, and 80%, respectively. AKI was associated with in-hospital mortality even after adjustment for confounders (OR, 5.12; 95% CI, 2.70 to 9.72).
Conclusions: AKI is uncommon but carries high in-hospital mortality in patients with COVID-19.
Keywords: COVID-19; acute kidney injury; mortality; prognosis; risk factors.