Acute kidney injury in hospitalized patients due to COVID-19 [article]

Pehuén Fernández, Emanuel José Saad, Augusto Douthat, Federico Ariel Marucco, María Celeste Heredia, Ayelén Tarditi Barra, Silvina Trinidad Rodriguez Bonazzi, Melani Zlotogora, María Antonella Correa Barovero, Sofía Villada, Juan Pablo Maldonado, Juan Pablo Caeiro (+3 others)
2021 medRxiv   pre-print
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 Córdoba, 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
more » ... Privado Universitario de Córdoba and Hospital Raúl 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 count at admission (aOR=1.09, 95%CI=1.01-1.18, p=0.037) and requirement for mechanical ventilation (MV) (aOR=6.69, 95%CI=2.24-19.9, p=0.001). AKI was associated with longer hospitalization, greater admission and length of stay in the intensive care unit, a positive association with bacterial superinfection, sepsis, respiratory distress syndrome, MV requirement and mortality (mortality with AKI=47.1% vs without AKI=12.4%, p<0.001). AKI was independently associated with higher mortality (aOR=3.32, 95%CI=1.6-6.9, p=0.001). In conclusion, the incidence of AKI in adults hospitalized for COVID-19 was 19% and had a clear impact on morbidity and mortality. Local predisposing factors for AKI were identified.
doi:10.1101/2021.05.31.21257656 fatcat:fnor2u464jdptngbx47dqwyu4u