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Kidney disease and all-cause mortality in patients with COVID-19 hospitalized in Genoa, Northern Italy
BACKGROUND: The prevalence of kidney involvement during SARS-CoV-2 infection has been reported to be high. Nevertheless, data are lacking about the determinants of acute kidney injury (AKI) and the combined effect of chronic kidney disease (CKD) and AKI in COVID-19 patients. METHODS: We collected da...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538179/ https://www.ncbi.nlm.nih.gov/pubmed/33025516 http://dx.doi.org/10.1007/s40620-020-00875-1 |
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author | Russo, Elisa Esposito, Pasquale Taramasso, Lucia Magnasco, Laura Saio, Michela Briano, Federica Russo, Chiara Dettori, Silvia Vena, Antonio Di Biagio, Antonio Garibotto, Giacomo Bassetti, Matteo Viazzi, Francesca |
author_facet | Russo, Elisa Esposito, Pasquale Taramasso, Lucia Magnasco, Laura Saio, Michela Briano, Federica Russo, Chiara Dettori, Silvia Vena, Antonio Di Biagio, Antonio Garibotto, Giacomo Bassetti, Matteo Viazzi, Francesca |
author_sort | Russo, Elisa |
collection | PubMed |
description | BACKGROUND: The prevalence of kidney involvement during SARS-CoV-2 infection has been reported to be high. Nevertheless, data are lacking about the determinants of acute kidney injury (AKI) and the combined effect of chronic kidney disease (CKD) and AKI in COVID-19 patients. METHODS: We collected data on patient demographics, comorbidities, chronic medications, vital signs, baseline laboratory test results and in-hospital treatment in patients with COVID-19 consecutively admitted to our Institution. Chronic kidney disease was defined as eGFR < 60 mL/min per 1.73 m(2) or proteinuria at urinalysis within 180 days prior to hospital admission. AKI was defined according to KDIGO criteria. The primary and secondary outcomes were the development of AKI and death. RESULTS: Of 777 patients eligible for the study, acute kidney injury developed in 176 (22.6%). Of these, 79 (45%) showed an acute worsening of a preexisting CKD, and 21 (12%) required kidney replacement therapy. Independent associates of AKI were chronic kidney disease, C-reactive protein (CRP) and ventilation support. Among patients with acute kidney injury, 111 died (63%) and its occurrence increased the risk of death by 60% (HR 1.60 [95% IC 1.21–2.49] p = 0.002) independently of potential confounding factors including hypertension, preexisting kidney damage, and comorbidities. Patients with AKI showed a significantly higher rate of deaths attributed to bleeding compared to CKD and the whole population (7.5 vs 1.5 vs 3.5%, respectively). CONCLUSION: Awareness of kidney function, both preexisting CKD and development of acute kidney injury, may help to identify those patients at increased risk of death. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40620-020-00875-1) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7538179 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-75381792020-10-07 Kidney disease and all-cause mortality in patients with COVID-19 hospitalized in Genoa, Northern Italy Russo, Elisa Esposito, Pasquale Taramasso, Lucia Magnasco, Laura Saio, Michela Briano, Federica Russo, Chiara Dettori, Silvia Vena, Antonio Di Biagio, Antonio Garibotto, Giacomo Bassetti, Matteo Viazzi, Francesca J Nephrol Original Article BACKGROUND: The prevalence of kidney involvement during SARS-CoV-2 infection has been reported to be high. Nevertheless, data are lacking about the determinants of acute kidney injury (AKI) and the combined effect of chronic kidney disease (CKD) and AKI in COVID-19 patients. METHODS: We collected data on patient demographics, comorbidities, chronic medications, vital signs, baseline laboratory test results and in-hospital treatment in patients with COVID-19 consecutively admitted to our Institution. Chronic kidney disease was defined as eGFR < 60 mL/min per 1.73 m(2) or proteinuria at urinalysis within 180 days prior to hospital admission. AKI was defined according to KDIGO criteria. The primary and secondary outcomes were the development of AKI and death. RESULTS: Of 777 patients eligible for the study, acute kidney injury developed in 176 (22.6%). Of these, 79 (45%) showed an acute worsening of a preexisting CKD, and 21 (12%) required kidney replacement therapy. Independent associates of AKI were chronic kidney disease, C-reactive protein (CRP) and ventilation support. Among patients with acute kidney injury, 111 died (63%) and its occurrence increased the risk of death by 60% (HR 1.60 [95% IC 1.21–2.49] p = 0.002) independently of potential confounding factors including hypertension, preexisting kidney damage, and comorbidities. Patients with AKI showed a significantly higher rate of deaths attributed to bleeding compared to CKD and the whole population (7.5 vs 1.5 vs 3.5%, respectively). CONCLUSION: Awareness of kidney function, both preexisting CKD and development of acute kidney injury, may help to identify those patients at increased risk of death. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40620-020-00875-1) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-10-06 2021 /pmc/articles/PMC7538179/ /pubmed/33025516 http://dx.doi.org/10.1007/s40620-020-00875-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article Russo, Elisa Esposito, Pasquale Taramasso, Lucia Magnasco, Laura Saio, Michela Briano, Federica Russo, Chiara Dettori, Silvia Vena, Antonio Di Biagio, Antonio Garibotto, Giacomo Bassetti, Matteo Viazzi, Francesca Kidney disease and all-cause mortality in patients with COVID-19 hospitalized in Genoa, Northern Italy |
title | Kidney disease and all-cause mortality in patients with COVID-19 hospitalized in Genoa, Northern Italy |
title_full | Kidney disease and all-cause mortality in patients with COVID-19 hospitalized in Genoa, Northern Italy |
title_fullStr | Kidney disease and all-cause mortality in patients with COVID-19 hospitalized in Genoa, Northern Italy |
title_full_unstemmed | Kidney disease and all-cause mortality in patients with COVID-19 hospitalized in Genoa, Northern Italy |
title_short | Kidney disease and all-cause mortality in patients with COVID-19 hospitalized in Genoa, Northern Italy |
title_sort | kidney disease and all-cause mortality in patients with covid-19 hospitalized in genoa, northern italy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538179/ https://www.ncbi.nlm.nih.gov/pubmed/33025516 http://dx.doi.org/10.1007/s40620-020-00875-1 |
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