Acute kidney injury in patients hospitalized with COVID-19
Date
2020Author
Hirsch, Jamie S.
Ng, Jia H.
Ross, Daniel W.
Sharma1, Purva
Shah, Hitesh H.
Barnett, Richard L.
Hazzan, Azzour D.
Fishbane, Steven
Jhaveri, Kenar D.
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Abstract
The rate of acute kidney injury (AKI) associated with
patients hospitalized with Covid-19, and associated
outcomes are not well understood. This study describes the
presentation, risk factors and outcomes of AKI in patients
hospitalized with Covid-19. We reviewed the health records
for all patients hospitalized with Covid-19 between March
1, and April 5, 2020, at 13 academic and community
hospitals in metropolitan New York. Patients younger than
18 years of age, with end stage kidney disease or with a
kidney transplant were excluded. AKI was defined
according to KDIGO criteria. Of 5,449 patients admitted
with Covid-19, AKI developed in 1,993 (36.6%). The peak
stages of AKI were stage 1 in 46.5%, stage 2 in 22.4% and
stage 3 in 31.1%. Of these, 14.3% required renal
replacement therapy (RRT). AKI was primarily seen in
Covid-19 patients with respiratory failure, with 89.7% of
patients on mechanical ventilation developing AKI
compared to 21.7% of non-ventilated patients. 276/285
(96.8%) of patients requiring RRT were on ventilators. Of
patients who required ventilation and developed AKI,
52.2% had the onset of AKI within 24 hours of intubation.
Risk factors for AKI included older age, diabetes mellitus,
cardiovascular disease, black race, hypertension and need
for ventilation and vasopressor medications. Among
patients with AKI, 694 died (35%), 519 (26%) were
discharged and 780 (39%) were still hospitalized. AKI
occurs frequently among patients with Covid-19 disease. It
occurs early and in temporal association with respiratory
failure and is associated with a poor prognosis.
Palabras clave
AKI; Continuous RRT; COVID-19; Dialysis; Renal failureLink to resource
https://doi.org/10.1016/j.kint.2020.05.006Collections
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