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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
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.
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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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