POS-062 Acute kidney injury in COVID-19 infection: What are the outcomes in South Africa?

Hougenhouck-Tulleken, Wesley van; Hussain, Moon Moon; Vale, Claudia Do

doi:10.1016/j.ekir.2021.03.068

Cited by 2 publications

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“… 11 , 14 The mortality rate among patients with COVID-19 with superimposed AKI remains exceptionally high. 15 , 16 There is a need to understand the different clinical presentations of COVID-19 and its impact on clinical outcomes. There is currently no evidence supporting the idea that the management of COVID-19 associated AKI should be different from other causes of AKI.…”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury among hospitalised patients who died due to COVID-19 in the Eastern Cape, South Africa

Kaswa

2023

South African Family Practice

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Background: Acute kidney injury (AKI) commonly occurs in coronavirus disease 2019 (COVID-19) patients who have been hospitalised and is associated with a poor prognosis. This study aimed to determine the incidence of AKI among COVID-19 patients who died in a regional hospital in South Africa.Methods: This retrospective record review was conducted at the Mthatha Regional Hospital in South Africa’s Eastern Cape province. Data were collected between 10 July 2020 and 31 January 2021.Results: The incidence of AKI was 38% among the hospitalised patients who died due to COVID-19. Most study participants were female, with a mean age of 63.3 ± 16 years. The most common symptom of COVID-19 at the time of hospitalisation was shortness of breath, followed by fever and cough. Half of the patients had hypertension, while diabetes, human immunodeficiency viruses (HIV) and tuberculosis (TB) were other comorbidities. At admission, the average oxygen saturation was 75.5% ± 17.Conclusion: The study revealed a high incidence of AKI among hospitalised patients who died due to COVID-19. It also found that those received adequate crystalloid fluids at the time of admission had a lower incidence of AKI.Contribution: Acute kidney injury can be prevented by adequate fluid management during early stage of COVID-19. Majority of COVID-19 patients were referred from lower level of care and primary care providers have their first encounter with these patients. Adequate fluid resuscitation in primary care settings can improve the outcome of hospitalised COVID-19 patients.

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Section: Introductionmentioning

confidence: 99%

Acute kidney injury among hospitalised patients who died due to COVID-19 in the Eastern Cape, South Africa

Kaswa

2023

South African Family Practice

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“…PR-AKI may occur due to obstetric complications such as septic abortion, peripartum hemorrhage, and puerperal sepsis in women with previous healthy kidneys [2], while hypertensive disorders of pregnancy and thrombotic micro-angiopathy account for the majority of PR-AKI cases in developed countries [3]. Owing to the physiological alterations of pregnancy, PR-AKI is often tricky to diagnose and is usually diagnosed too late, that is, after substantial kidney damage has occurred [4]. In addition, the proposed AKI criteria for nonpregnant patients have not been validated in pregnancy [5,6], although serum creatinine of 77 mmol/l (0.87 mg/dl) or more has been considered outside the normal range for pregnancy [7].…”

Section: Introductionmentioning

confidence: 99%

Urinary congophilia in pregnancy: a marker of kidney injury rather than preeclampsia

Younis,

Mosbah,

Zakaria

et al. 2023

Journal of Hypertension

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Background: The differentiation between preeclampsia and similarly presenting kidney disease in pregnancy is a diagnostic challenge. Although some laboratory tests have been utilized, globally validated tools are yet needed, particularly in resource-limited settings. Congophilic proteins are abundantly detected in the urine of pregnant women who develop preeclampsia that is thought to be a marker of disease process. The present study aimed to assess the diagnostic and predictive utility of urinary congophilia in pregnant women with hypertensive disorders of pregnancy as well as kidney diseases. Methods: This cohort study included 157 pregnant women, classified as healthy controls (n = 38), preeclampsia/eclampsia (n = 45), gestational hypertension (n = 9), chronic hypertension (n = 8), chronic kidney disease (CKD) (n = 27), and pregnancy-related acute kidney injury (PR-AKI) (n = 30). Urinary congophilia was assessed by Congo Red Dot Blot assay. Results: Congo red retention (CRR) values were significantly higher in women with preeclampsia/eclampsia (P ≤ 0.001), chronic hypertension (P = 0.029), gestational hypertension (P = 0.017), CKD (P ≤ 0.001), PR-AKI secondary to preeclampsia (P ≤ 0.001), and PR-AKI secondary to other causes (P = 0.001), compared with healthy controls. Women with preeclampsia, CKD, and PR-AKI (non-preeclampsia related) exhibited the highest levels of CRR. CRR positively correlated to proteinuria (P = 0.006) and serum creatinine (P = 0.027). CRR did not significantly vary between women who presented antepartum and those presented postpartum after removal of the placenta (P = 0.707). CRR at a cut-off point of at least 1.272 had 91% specificity and 61.1% sensitivity in predicting renal recovery in PR-AKI patients. CRR had a poor specificity in discriminating preeclampsia from the other clinical presentations. Conclusion: Urinary congophilia could not discriminate preeclampsia from similarly presenting kidney diseases in pregnancy. Further studies are needed to improve differentiation of these conditions.

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POS-062 Acute kidney injury in COVID-19 infection: What are the outcomes in South Africa?

Cited by 2 publications

References 0 publications

Acute kidney injury among hospitalised patients who died due to COVID-19 in the Eastern Cape, South Africa

Acute kidney injury among hospitalised patients who died due to COVID-19 in the Eastern Cape, South Africa

Urinary congophilia in pregnancy: a marker of kidney injury rather than preeclampsia

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