tetano
Editor, Senior Moderator
Kidney Dis (Basel)
. 2021 Mar;7(2):111-119.
doi: 10.1159/000512270. Epub 2020 Oct 26.
Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019
Yichun Cheng[SUP] 1 [/SUP], Nanhui Zhang[SUP] 1 [/SUP], Ran Luo[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] 1 [/SUP], Gang Xu[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat with a great number of deaths worldwide. Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit. We aimed to assess the incidence, risk factors and in-hospital outcomes of AKI in COVID-19 patients admitted to the intensive care unit.
Methods: We conducted a retrospective observational study in the intensive care unit of Tongji Hospital, which was assigned responsibility for the treatments of severe COVID-19 patients by the Wuhan government. AKI was defined and staged based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Mild AKI was defined as stage 1, and severe AKI was defined as stage 2 or stage 3. Logistic regression analysis was used to evaluate AKI risk factors, and Cox proportional hazards model was used to assess the association between AKI and in-hospital mortality.
Results: A total of 119 patients with COVID-19 were included in our study. The median patient age was 70 years (interquartile range, 59-77) and 61.3% were male. Fifty-one (42.8%) patients developed AKI during hospitalization, corresponding to 14.3% in stage 1, 28.6% in stage 2 and 18.5% in stage 3, respectively. Compared to patients without AKI, patients with AKI had a higher proportion of mechanical ventilation mortality and higher in-hospital mortality. A total of 97.1% of patients with severe AKI received mechanical ventilation and in-hospital mortality was up to 79.4%. Severe AKI was independently associated with high in-hospital mortality (OR: 1.82; 95% CI: 1.06-3.13). Logistic regression analysis demonstrated that high serum interleukin-8 (OR: 4.21; 95% CI: 1.23-14.38), interleukin-10 (OR: 3.32; 95% CI: 1.04-10.59) and interleukin-2 receptor (OR: 4.50; 95% CI: 0.73-6.78) were risk factors for severe AKI development.
Conclusions: Severe AKI was associated with high in-hospital mortality, and inflammatory response may play a role in AKI development in critically ill patients with COVID-19.
Keywords: Acute kidney injury; Coronavirus disease 2019; Mortality; Risk factor.
. 2021 Mar;7(2):111-119.
doi: 10.1159/000512270. Epub 2020 Oct 26.
Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019
Yichun Cheng[SUP] 1 [/SUP], Nanhui Zhang[SUP] 1 [/SUP], Ran Luo[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] 1 [/SUP], Gang Xu[SUP] 1 [/SUP]
Affiliations
- PMID: 33821208
- PMCID: PMC7649690
- DOI: 10.1159/000512270
Abstract
Background: Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat with a great number of deaths worldwide. Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit. We aimed to assess the incidence, risk factors and in-hospital outcomes of AKI in COVID-19 patients admitted to the intensive care unit.
Methods: We conducted a retrospective observational study in the intensive care unit of Tongji Hospital, which was assigned responsibility for the treatments of severe COVID-19 patients by the Wuhan government. AKI was defined and staged based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Mild AKI was defined as stage 1, and severe AKI was defined as stage 2 or stage 3. Logistic regression analysis was used to evaluate AKI risk factors, and Cox proportional hazards model was used to assess the association between AKI and in-hospital mortality.
Results: A total of 119 patients with COVID-19 were included in our study. The median patient age was 70 years (interquartile range, 59-77) and 61.3% were male. Fifty-one (42.8%) patients developed AKI during hospitalization, corresponding to 14.3% in stage 1, 28.6% in stage 2 and 18.5% in stage 3, respectively. Compared to patients without AKI, patients with AKI had a higher proportion of mechanical ventilation mortality and higher in-hospital mortality. A total of 97.1% of patients with severe AKI received mechanical ventilation and in-hospital mortality was up to 79.4%. Severe AKI was independently associated with high in-hospital mortality (OR: 1.82; 95% CI: 1.06-3.13). Logistic regression analysis demonstrated that high serum interleukin-8 (OR: 4.21; 95% CI: 1.23-14.38), interleukin-10 (OR: 3.32; 95% CI: 1.04-10.59) and interleukin-2 receptor (OR: 4.50; 95% CI: 0.73-6.78) were risk factors for severe AKI development.
Conclusions: Severe AKI was associated with high in-hospital mortality, and inflammatory response may play a role in AKI development in critically ill patients with COVID-19.
Keywords: Acute kidney injury; Coronavirus disease 2019; Mortality; Risk factor.