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Acute kidney injury in 3182 patients admitted with COVID-19: a single-center, retrospective, case–control study
BACKGROUND: Acute kidney injury (AKI) may develop in coronavirus disease 2019 (COVID-19) patients and may be associated with a worse outcome. The aim of this study is to describe AKI incidence during the first 45 days of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Sp...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929007/ https://www.ncbi.nlm.nih.gov/pubmed/34079618 http://dx.doi.org/10.1093/ckj/sfab021 |
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author | Procaccini, Fabio L Alcázar Arroyo, Roberto Albalate Ramón, Marta Torres Aguilera, Esther Martín Navarro, Juan Ryan Murua, Pablo Cintra Cabrera, Melissa Ortega Díaz, Mayra Puerta Carretero, Marta de Sequera Ortiz, Patricia |
author_facet | Procaccini, Fabio L Alcázar Arroyo, Roberto Albalate Ramón, Marta Torres Aguilera, Esther Martín Navarro, Juan Ryan Murua, Pablo Cintra Cabrera, Melissa Ortega Díaz, Mayra Puerta Carretero, Marta de Sequera Ortiz, Patricia |
author_sort | Procaccini, Fabio L |
collection | PubMed |
description | BACKGROUND: Acute kidney injury (AKI) may develop in coronavirus disease 2019 (COVID-19) patients and may be associated with a worse outcome. The aim of this study is to describe AKI incidence during the first 45 days of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Spain, its reversibility and the association with mortality. METHODS: This was an observational retrospective case–control study based on patients hospitalized between 1 March and 15 April 2020 with SARS-CoV-2 infection and AKI. Confirmed AKI cases were compared with stable kidney function patients for baseline characteristics, analytical data, treatment and renal outcome. Patients with end-stage kidney disease were excluded. RESULTS: AKI incidence was 17.22% among 3182 admitted COVID-19 patients and acute kidney disease (AKD) incidence was 6.82%. The most frequent causes of AKI were prerenal (68.8%) and sepsis (21.9%). Odds ratio (OR) for AKI was increased in patients with pre-existent hypertension [OR 2.58, 95% confidence interval (CI) 1.71–3.89] and chronic kidney disease (CKD) (OR 2.14, 95% CI 1.33–3.42) and in those with respiratory distress (OR 2.37, 95% CI 1.52–3.70). Low arterial pressure at admission increased the risk for Stage 3 AKI (OR 1.65, 95% CI 1.09–2.50). Baseline kidney function was not recovered in 45.73% of overall AKI cases and in 52.75% of AKI patients with prior CKD. Mortality was 38.5% compared with 13.4% of the overall sample population. AKI increased mortality risk at any time of hospitalization (hazard ratio 1.45, 95% CI 1.09–1.93). CONCLUSIONS: AKI is frequent in COVID-19 patients and is associated with mortality, independently of acute respiratory distress syndrome. AKD was also frequent and merits adequate follow-up. |
format | Online Article Text |
id | pubmed-7929007 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-79290072021-03-04 Acute kidney injury in 3182 patients admitted with COVID-19: a single-center, retrospective, case–control study Procaccini, Fabio L Alcázar Arroyo, Roberto Albalate Ramón, Marta Torres Aguilera, Esther Martín Navarro, Juan Ryan Murua, Pablo Cintra Cabrera, Melissa Ortega Díaz, Mayra Puerta Carretero, Marta de Sequera Ortiz, Patricia Clin Kidney J Original Articles BACKGROUND: Acute kidney injury (AKI) may develop in coronavirus disease 2019 (COVID-19) patients and may be associated with a worse outcome. The aim of this study is to describe AKI incidence during the first 45 days of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Spain, its reversibility and the association with mortality. METHODS: This was an observational retrospective case–control study based on patients hospitalized between 1 March and 15 April 2020 with SARS-CoV-2 infection and AKI. Confirmed AKI cases were compared with stable kidney function patients for baseline characteristics, analytical data, treatment and renal outcome. Patients with end-stage kidney disease were excluded. RESULTS: AKI incidence was 17.22% among 3182 admitted COVID-19 patients and acute kidney disease (AKD) incidence was 6.82%. The most frequent causes of AKI were prerenal (68.8%) and sepsis (21.9%). Odds ratio (OR) for AKI was increased in patients with pre-existent hypertension [OR 2.58, 95% confidence interval (CI) 1.71–3.89] and chronic kidney disease (CKD) (OR 2.14, 95% CI 1.33–3.42) and in those with respiratory distress (OR 2.37, 95% CI 1.52–3.70). Low arterial pressure at admission increased the risk for Stage 3 AKI (OR 1.65, 95% CI 1.09–2.50). Baseline kidney function was not recovered in 45.73% of overall AKI cases and in 52.75% of AKI patients with prior CKD. Mortality was 38.5% compared with 13.4% of the overall sample population. AKI increased mortality risk at any time of hospitalization (hazard ratio 1.45, 95% CI 1.09–1.93). CONCLUSIONS: AKI is frequent in COVID-19 patients and is associated with mortality, independently of acute respiratory distress syndrome. AKD was also frequent and merits adequate follow-up. Oxford University Press 2021-01-28 /pmc/articles/PMC7929007/ /pubmed/34079618 http://dx.doi.org/10.1093/ckj/sfab021 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Articles Procaccini, Fabio L Alcázar Arroyo, Roberto Albalate Ramón, Marta Torres Aguilera, Esther Martín Navarro, Juan Ryan Murua, Pablo Cintra Cabrera, Melissa Ortega Díaz, Mayra Puerta Carretero, Marta de Sequera Ortiz, Patricia Acute kidney injury in 3182 patients admitted with COVID-19: a single-center, retrospective, case–control study |
title | Acute kidney injury in 3182 patients admitted with COVID-19: a single-center, retrospective, case–control study |
title_full | Acute kidney injury in 3182 patients admitted with COVID-19: a single-center, retrospective, case–control study |
title_fullStr | Acute kidney injury in 3182 patients admitted with COVID-19: a single-center, retrospective, case–control study |
title_full_unstemmed | Acute kidney injury in 3182 patients admitted with COVID-19: a single-center, retrospective, case–control study |
title_short | Acute kidney injury in 3182 patients admitted with COVID-19: a single-center, retrospective, case–control study |
title_sort | acute kidney injury in 3182 patients admitted with covid-19: a single-center, retrospective, case–control study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929007/ https://www.ncbi.nlm.nih.gov/pubmed/34079618 http://dx.doi.org/10.1093/ckj/sfab021 |
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