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Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality

Although the lungs are major targets for COVID-19 invasion, other organs—such as the kidneys—are also affected. However, the renal complications of COVID-19 are not yet well explored. This study aimed to identify the incidence of acute kidney injury (AKI) in patients with COVID-19 and to evaluate it...

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Autores principales: Paek, Jin Hyuk, Kim, Yaerim, Park, Woo Yeong, Jin, Kyubok, Hyun, Miri, Lee, Ji Yeon, Kim, Hyun Ah, Kwon, Yong Shik, Park, Jae Seok, Han, Seungyeup
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725289/
https://www.ncbi.nlm.nih.gov/pubmed/33296419
http://dx.doi.org/10.1371/journal.pone.0243528
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author Paek, Jin Hyuk
Kim, Yaerim
Park, Woo Yeong
Jin, Kyubok
Hyun, Miri
Lee, Ji Yeon
Kim, Hyun Ah
Kwon, Yong Shik
Park, Jae Seok
Han, Seungyeup
author_facet Paek, Jin Hyuk
Kim, Yaerim
Park, Woo Yeong
Jin, Kyubok
Hyun, Miri
Lee, Ji Yeon
Kim, Hyun Ah
Kwon, Yong Shik
Park, Jae Seok
Han, Seungyeup
author_sort Paek, Jin Hyuk
collection PubMed
description Although the lungs are major targets for COVID-19 invasion, other organs—such as the kidneys—are also affected. However, the renal complications of COVID-19 are not yet well explored. This study aimed to identify the incidence of acute kidney injury (AKI) in patients with COVID-19 and to evaluate its impact on patient outcomes. This retrospective study included 704 patients with COVID-19 who were hospitalized at two hospitals in Daegu, Korea from February 19 to March 31, 2020. AKI was defined according to the serum creatinine criteria in the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The final date of follow-up was May 1, 2020. Of the 704 patients, 28 (4.0%) developed AKI. Of the 28 patients with AKI, 15 (53.6%) were found to have AKI stage 1, 3 (10.7%) had AKI stage 2, and 10 (35.7%) had AKI stage 3. Among these patients, 12 (42.9%) recovered from AKI. In the patients with AKI, the rates of admission to intensive care unit (ICU), administration of mechanical ventilator (MV), and in-hospital mortality were significantly higher than in patients without AKI. Multivariable analysis revealed that old age (Hazard ratio [HR] = 4.668, 95% confidence interval [CI] = 1.250–17.430, p = 0.022), high neutrophil-to-lymphocyte ratio (HR = 1.167, 95% CI = 1.078–1.264, p < 0.001), elevated creatinine kinase (HR = 1.002, 95% CI = 1.001–1.004, p = 0.007), and severe AKI (HR = 12.199, 95% CI = 4.235–35.141, p < 0.001) were independent risk factors for in-hospital mortality. The Kaplan-Meier curves showed that the cumulative survival rate was lowest in the AKI stage 3 group (p < 0.001). In conclusion, the incidence of AKI in patients with COVID-19 was 4.0%. Severe AKI was associated with in-hospital death.
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spelling pubmed-77252892020-12-16 Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality Paek, Jin Hyuk Kim, Yaerim Park, Woo Yeong Jin, Kyubok Hyun, Miri Lee, Ji Yeon Kim, Hyun Ah Kwon, Yong Shik Park, Jae Seok Han, Seungyeup PLoS One Research Article Although the lungs are major targets for COVID-19 invasion, other organs—such as the kidneys—are also affected. However, the renal complications of COVID-19 are not yet well explored. This study aimed to identify the incidence of acute kidney injury (AKI) in patients with COVID-19 and to evaluate its impact on patient outcomes. This retrospective study included 704 patients with COVID-19 who were hospitalized at two hospitals in Daegu, Korea from February 19 to March 31, 2020. AKI was defined according to the serum creatinine criteria in the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The final date of follow-up was May 1, 2020. Of the 704 patients, 28 (4.0%) developed AKI. Of the 28 patients with AKI, 15 (53.6%) were found to have AKI stage 1, 3 (10.7%) had AKI stage 2, and 10 (35.7%) had AKI stage 3. Among these patients, 12 (42.9%) recovered from AKI. In the patients with AKI, the rates of admission to intensive care unit (ICU), administration of mechanical ventilator (MV), and in-hospital mortality were significantly higher than in patients without AKI. Multivariable analysis revealed that old age (Hazard ratio [HR] = 4.668, 95% confidence interval [CI] = 1.250–17.430, p = 0.022), high neutrophil-to-lymphocyte ratio (HR = 1.167, 95% CI = 1.078–1.264, p < 0.001), elevated creatinine kinase (HR = 1.002, 95% CI = 1.001–1.004, p = 0.007), and severe AKI (HR = 12.199, 95% CI = 4.235–35.141, p < 0.001) were independent risk factors for in-hospital mortality. The Kaplan-Meier curves showed that the cumulative survival rate was lowest in the AKI stage 3 group (p < 0.001). In conclusion, the incidence of AKI in patients with COVID-19 was 4.0%. Severe AKI was associated with in-hospital death. Public Library of Science 2020-12-09 /pmc/articles/PMC7725289/ /pubmed/33296419 http://dx.doi.org/10.1371/journal.pone.0243528 Text en © 2020 Paek et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Paek, Jin Hyuk
Kim, Yaerim
Park, Woo Yeong
Jin, Kyubok
Hyun, Miri
Lee, Ji Yeon
Kim, Hyun Ah
Kwon, Yong Shik
Park, Jae Seok
Han, Seungyeup
Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality
title Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality
title_full Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality
title_fullStr Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality
title_full_unstemmed Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality
title_short Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality
title_sort severe acute kidney injury in covid-19 patients is associated with in-hospital mortality
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725289/
https://www.ncbi.nlm.nih.gov/pubmed/33296419
http://dx.doi.org/10.1371/journal.pone.0243528
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