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Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19
Background: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients is variable and has been associated with worse prognosis. A significant number of patients develop persistent kidney damage defined as Acute Kidney Disease (AKD). There is a lack of evidence on the real impact of AKD on...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509682/ https://www.ncbi.nlm.nih.gov/pubmed/34640618 http://dx.doi.org/10.3390/jcm10194599 |
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author | Marques, Filipe Gameiro, Joana Oliveira, João Fonseca, José Agapito Duarte, Inês Bernardo, João Branco, Carolina Costa, Claúdia Carreiro, Carolina Braz, Sandra Lopes, José António |
author_facet | Marques, Filipe Gameiro, Joana Oliveira, João Fonseca, José Agapito Duarte, Inês Bernardo, João Branco, Carolina Costa, Claúdia Carreiro, Carolina Braz, Sandra Lopes, José António |
author_sort | Marques, Filipe |
collection | PubMed |
description | Background: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients is variable and has been associated with worse prognosis. A significant number of patients develop persistent kidney damage defined as Acute Kidney Disease (AKD). There is a lack of evidence on the real impact of AKD on COVID-19 patients. We aim to identify risk factors for the development of AKD and its impact on mortality in COVID-19 patients. Methods: Retrospective analysis of COVID-19 patients with AKI admitted at the Centro Hospitalar Universitário Lisboa Norte between March and August of 2020. The Kidney Disease Improving Global Outcomes (KDIGO) classification was used to define AKI. AKD was defined by presenting at least KDIGO Stage 1 criteria for >7 days after an AKI initiating event. Results: In 339 COVID-19 patients with AKI, 25.7% patients developed AKD (n = 87). The mean age was 71.7 ± 17.0 years, baseline SCr was 1.03 ± 0.44 mg/dL, and the majority of patients were classified as KDIGO stage 3 AKI (54.3%). The in-hospital mortality was 18.0% (n = 61). Presence of hypertension (p = 0.006), CKD (p < 0.001), lower hemoglobin (p = 0.034) and lower CRP (p = 0.004) at the hospital admission and nephrotoxin exposure (p < 0.001) were independent risk factors for the development of AKD. Older age (p = 0.003), higher serum ferritin at admission (p = 0.008) and development of AKD (p = 0.029) were independent predictors of in-hospital mortality in COVID-19-AKI patients. Conclusions: AKD was significantly associated with in-hospital mortality in this population of COVID-19-AKI patients. Considering the significant risk of mortality in AKI patients, it is of paramount importance to identify the subset of higher risk patients. |
format | Online Article Text |
id | pubmed-8509682 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85096822021-10-13 Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19 Marques, Filipe Gameiro, Joana Oliveira, João Fonseca, José Agapito Duarte, Inês Bernardo, João Branco, Carolina Costa, Claúdia Carreiro, Carolina Braz, Sandra Lopes, José António J Clin Med Article Background: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients is variable and has been associated with worse prognosis. A significant number of patients develop persistent kidney damage defined as Acute Kidney Disease (AKD). There is a lack of evidence on the real impact of AKD on COVID-19 patients. We aim to identify risk factors for the development of AKD and its impact on mortality in COVID-19 patients. Methods: Retrospective analysis of COVID-19 patients with AKI admitted at the Centro Hospitalar Universitário Lisboa Norte between March and August of 2020. The Kidney Disease Improving Global Outcomes (KDIGO) classification was used to define AKI. AKD was defined by presenting at least KDIGO Stage 1 criteria for >7 days after an AKI initiating event. Results: In 339 COVID-19 patients with AKI, 25.7% patients developed AKD (n = 87). The mean age was 71.7 ± 17.0 years, baseline SCr was 1.03 ± 0.44 mg/dL, and the majority of patients were classified as KDIGO stage 3 AKI (54.3%). The in-hospital mortality was 18.0% (n = 61). Presence of hypertension (p = 0.006), CKD (p < 0.001), lower hemoglobin (p = 0.034) and lower CRP (p = 0.004) at the hospital admission and nephrotoxin exposure (p < 0.001) were independent risk factors for the development of AKD. Older age (p = 0.003), higher serum ferritin at admission (p = 0.008) and development of AKD (p = 0.029) were independent predictors of in-hospital mortality in COVID-19-AKI patients. Conclusions: AKD was significantly associated with in-hospital mortality in this population of COVID-19-AKI patients. Considering the significant risk of mortality in AKI patients, it is of paramount importance to identify the subset of higher risk patients. MDPI 2021-10-06 /pmc/articles/PMC8509682/ /pubmed/34640618 http://dx.doi.org/10.3390/jcm10194599 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Marques, Filipe Gameiro, Joana Oliveira, João Fonseca, José Agapito Duarte, Inês Bernardo, João Branco, Carolina Costa, Claúdia Carreiro, Carolina Braz, Sandra Lopes, José António Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19 |
title | Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19 |
title_full | Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19 |
title_fullStr | Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19 |
title_full_unstemmed | Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19 |
title_short | Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19 |
title_sort | acute kidney disease and mortality in acute kidney injury patients with covid-19 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509682/ https://www.ncbi.nlm.nih.gov/pubmed/34640618 http://dx.doi.org/10.3390/jcm10194599 |
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