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In hospital risk factors for acute kidney injury and its burden in patients with Sars-Cov-2 infection: a longitudinal multinational study

Acute kidney injury (AKI) is associated with increased mortality in most critical settings. However, it is unclear whether its mild form (i.e. AKI stage 1) is associated with increased mortality also in non-critical settings. Here we conducted an international study in patients hospitalized with SAR...

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Autores principales: Morieri, Mario Luca, Ronco, Claudio, Avogaro, Angelo, Farnia, Filippo, Shestakova, Marina, Zaytseva, Natalya, Mokrysheva, Natalya, Akulkina, Larisa, Shepalina, Anastasia, Brovko, Michail, Moiseev, Sergey, Russo, Lucia, Mazzocut, Sara, Vianello, Andrea, Cattellan, Anna Maria, Vedovato, Monica, Fadini, Gian Paolo, Vettor, Roberto, Fioretto, Paola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891366/
https://www.ncbi.nlm.nih.gov/pubmed/35236891
http://dx.doi.org/10.1038/s41598-022-07490-z
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author Morieri, Mario Luca
Ronco, Claudio
Avogaro, Angelo
Farnia, Filippo
Shestakova, Marina
Zaytseva, Natalya
Mokrysheva, Natalya
Akulkina, Larisa
Shepalina, Anastasia
Brovko, Michail
Moiseev, Sergey
Russo, Lucia
Mazzocut, Sara
Vianello, Andrea
Cattellan, Anna Maria
Vedovato, Monica
Fadini, Gian Paolo
Vettor, Roberto
Fioretto, Paola
author_facet Morieri, Mario Luca
Ronco, Claudio
Avogaro, Angelo
Farnia, Filippo
Shestakova, Marina
Zaytseva, Natalya
Mokrysheva, Natalya
Akulkina, Larisa
Shepalina, Anastasia
Brovko, Michail
Moiseev, Sergey
Russo, Lucia
Mazzocut, Sara
Vianello, Andrea
Cattellan, Anna Maria
Vedovato, Monica
Fadini, Gian Paolo
Vettor, Roberto
Fioretto, Paola
author_sort Morieri, Mario Luca
collection PubMed
description Acute kidney injury (AKI) is associated with increased mortality in most critical settings. However, it is unclear whether its mild form (i.e. AKI stage 1) is associated with increased mortality also in non-critical settings. Here we conducted an international study in patients hospitalized with SARS-CoV-2 infection aiming 1. to estimate the incidence of AKI at each stage and its impact on mortality 2. to identify AKI risk factors at admission (susceptibility) and during hospitalization (exposures) and factors contributing to AKI-associated mortality. We included 939 patients from medical departments in Moscow (Russia) and Padua (Italy). In-hospital AKI onset was identified in 140 (14.9%) patients, mainly with stage 1 (65%). Mortality was remarkably higher in patients with AKI compared to those without AKI (55 [39.3%] vs. 34 [4.3%], respectively). Such association remained significant after adjustment for other clinical conditions at admission (relative risk [RR] 5.6; CI 3.5- 8.8) or restricting to AKI stage 1 (RR 3.2; CI 1.8–5.5) or to subjects with AKI onset preceding deterioration of clinical conditions. After hospital admission, worsening of hypoxic damage, inflammation, hyperglycemia, and coagulopathy were identified as hospital-acquired risk factors predicting AKI onset. Following AKI onset, the AKI-associated worsening of respiratory function was identified as the main contributor to AKI-induced increase in mortality risk. In conclusion, AKI is a common complication of Sars-CoV2 infection in non-intensive care settings where it markedly increases mortality risk also at stage 1. The identification of hospital-acquired risk factors and exposures might help prevention of AKI onset and of its complications.
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spelling pubmed-88913662022-03-07 In hospital risk factors for acute kidney injury and its burden in patients with Sars-Cov-2 infection: a longitudinal multinational study Morieri, Mario Luca Ronco, Claudio Avogaro, Angelo Farnia, Filippo Shestakova, Marina Zaytseva, Natalya Mokrysheva, Natalya Akulkina, Larisa Shepalina, Anastasia Brovko, Michail Moiseev, Sergey Russo, Lucia Mazzocut, Sara Vianello, Andrea Cattellan, Anna Maria Vedovato, Monica Fadini, Gian Paolo Vettor, Roberto Fioretto, Paola Sci Rep Article Acute kidney injury (AKI) is associated with increased mortality in most critical settings. However, it is unclear whether its mild form (i.e. AKI stage 1) is associated with increased mortality also in non-critical settings. Here we conducted an international study in patients hospitalized with SARS-CoV-2 infection aiming 1. to estimate the incidence of AKI at each stage and its impact on mortality 2. to identify AKI risk factors at admission (susceptibility) and during hospitalization (exposures) and factors contributing to AKI-associated mortality. We included 939 patients from medical departments in Moscow (Russia) and Padua (Italy). In-hospital AKI onset was identified in 140 (14.9%) patients, mainly with stage 1 (65%). Mortality was remarkably higher in patients with AKI compared to those without AKI (55 [39.3%] vs. 34 [4.3%], respectively). Such association remained significant after adjustment for other clinical conditions at admission (relative risk [RR] 5.6; CI 3.5- 8.8) or restricting to AKI stage 1 (RR 3.2; CI 1.8–5.5) or to subjects with AKI onset preceding deterioration of clinical conditions. After hospital admission, worsening of hypoxic damage, inflammation, hyperglycemia, and coagulopathy were identified as hospital-acquired risk factors predicting AKI onset. Following AKI onset, the AKI-associated worsening of respiratory function was identified as the main contributor to AKI-induced increase in mortality risk. In conclusion, AKI is a common complication of Sars-CoV2 infection in non-intensive care settings where it markedly increases mortality risk also at stage 1. The identification of hospital-acquired risk factors and exposures might help prevention of AKI onset and of its complications. Nature Publishing Group UK 2022-03-02 /pmc/articles/PMC8891366/ /pubmed/35236891 http://dx.doi.org/10.1038/s41598-022-07490-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This 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/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Morieri, Mario Luca
Ronco, Claudio
Avogaro, Angelo
Farnia, Filippo
Shestakova, Marina
Zaytseva, Natalya
Mokrysheva, Natalya
Akulkina, Larisa
Shepalina, Anastasia
Brovko, Michail
Moiseev, Sergey
Russo, Lucia
Mazzocut, Sara
Vianello, Andrea
Cattellan, Anna Maria
Vedovato, Monica
Fadini, Gian Paolo
Vettor, Roberto
Fioretto, Paola
In hospital risk factors for acute kidney injury and its burden in patients with Sars-Cov-2 infection: a longitudinal multinational study
title In hospital risk factors for acute kidney injury and its burden in patients with Sars-Cov-2 infection: a longitudinal multinational study
title_full In hospital risk factors for acute kidney injury and its burden in patients with Sars-Cov-2 infection: a longitudinal multinational study
title_fullStr In hospital risk factors for acute kidney injury and its burden in patients with Sars-Cov-2 infection: a longitudinal multinational study
title_full_unstemmed In hospital risk factors for acute kidney injury and its burden in patients with Sars-Cov-2 infection: a longitudinal multinational study
title_short In hospital risk factors for acute kidney injury and its burden in patients with Sars-Cov-2 infection: a longitudinal multinational study
title_sort in hospital risk factors for acute kidney injury and its burden in patients with sars-cov-2 infection: a longitudinal multinational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891366/
https://www.ncbi.nlm.nih.gov/pubmed/35236891
http://dx.doi.org/10.1038/s41598-022-07490-z
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