The Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study

Moledina, Dennis G.; Simonov, Michael; Yamamoto, Yu; Alausa, Jameel; Arora, Tanima; Biswas, Aditya; Cantley, Lloyd G.; Ghazi, Lama; Greenberg, Jason; Hinchcliff, Monique; Huang, Chenxi; Mansour, Sherry G.; Martin, Melissa; Peixoto, Aldo J.; Schulz, Wade; Subair, Labeebah; Testani, Jeffrey M.; Ugwuowo, Ugochukwu; Young, Patrick; Wilson, F. Perry

doi:10.1053/j.ajkd.2020.12.007

Cited by 74 publications

(77 citation statements)

References 33 publications

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“…A higher rate of AKI has been reported in COVID-19 patients compared to patients with similar traditional risk factors. Besides, COVID-19 was found independently associated with a high rate of AKI after fully adjusted by traditional risk factors [ 23 ]. Based on these findings, validation studies of previous AKI risk scores are necessary before they can be used to predict AKI in COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

“…A recent cohort study compared the AKI rates between patients with or without COVID-19 based on an extended cohort study including 22,122 hospitalized patients of whom 2600 tested positive for SARS-CoV-2. The authors found COVID-19 was independently associated with higher rates of AKI (HR = 1.4, 95%CI 1.29–1.53) after fully adjusted by traditional AKI risk factors suggesting the presence of a unique mechanism of COVID-19 which may include a direct effect of COVID-19 [ 23 ]. Based on these findings, a validation study of any previous AKI risk score is necessary before it can be used to predict AKI in COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

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A validation study of UCSD-Mayo risk score in predicting hospital-acquired acute kidney injury in COVID-19 patients

et al. 2021

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Introduction: Acute kidney injury (AKI) in coronavirus disease 2019 patients is associated with poor prognosis. Early prediction and intervention of AKI are vital for improving clinical outcome of COVID-19 patients. As lack of tools for early AKI detection in COVID-19 patients, this study aimed to validate the USCD-Mayo risk score in predicting hospital-acquired AKI in an extended multi-center COVID-19 cohort. Methods: Five hundred seventy-two COVID-19 patients from Wuhan Tongji Hospital Guanggu Branch, Wuhan Leishenshan Hospital, and Wuhan No. Ninth Hospital was enrolled for this study. Patients who developed AKI or reached an outcome of recovery or death during the study period were included. Predictors were evaluated according to data extracted from medical records. Results: Of all patients, a total of 44 (8%) developed AKI. The UCSD-Mayo risk score achieved excellent discrimination in predicting AKI with the C-statistic of 0.88 (95%CI: 0.84-0.91). Next, we determined the UCSD-Mayo risk score had good overall performance (Nagelkerke R 2 ¼ 0.32) and calibration in our cohort. Further analysis showed that the UCSD-Mayo risk score performed well in subgroups defined by gender, age, and several chronic comorbidities. However, the discrimination of the UCSD-Mayo risk score in ICU patients and patients with mechanical ventilation was not good which might be resulted from different risk factors of these patients. Conclusions: We validated the performance of UCSD-Mayo risk score in predicting hospitalacquired AKI in COVID-19 patients was excellent except for patients from ICU or patients with mechanical ventilation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A validation study of UCSD-Mayo risk score in predicting hospital-acquired acute kidney injury in COVID-19 patients

et al. 2021

View full text Add to dashboard Cite

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Section: Discussionmentioning

confidence: 99%

“…A recent multicenter cohort study further introduced how occurrence of AKI remained associated with COVID-19 and was not fully explained by adjustment for known renal risk factors such as demographic variables, comorbidities, and laboratory results. 29 Whether the mechanism by which COVID-19 causes AKI is shared with other infections, its association with poor outcomes is very consistent. A meta-analysis of AKI in a mixture of surgical and critical care settings suggests mild, moderate, and severe AKI are associated with risk ratios for death of 1.67, 2.73, and 3.04, respectively.…”

Section: In Relation To Aki In Other Diseasementioning

confidence: 99%

Incidence and Outcomes of Acute Kidney Injury in Patients Admitted to Hospital With COVID-19: A Retrospective Cohort Study

Pitre

Jones

et al. 2021

Can J Kidney Health Dis

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Background: The incidence of acute kidney injury (AKI) in patients with COVID-19 and its association with mortality and disease severity is understudied in the Canadian population. Objective: To determine the incidence of AKI in a cohort of patients with COVID-19 admitted to medicine and intensive care unit (ICU) wards, its association with in-hospital mortality, and disease severity. Our aim was to stratify these outcomes by out-of-hospital AKI and in-hospital AKI. Design: Retrospective cohort study from a registry of patients with COVID-19. Setting: Three community and 3 academic hospitals. Patients: A total of 815 patients admitted to hospital with COVID-19 between March 4, 2020, and April 23, 2021. Measurements: Stage of AKI, ICU admission, mechanical ventilation, and in-hospital mortality. Methods: We classified AKI by comparing highest to lowest recorded serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global Outcomes (KDIGO) system. We calculated the unadjusted and adjusted odds ratio for the stage of AKI and the outcomes of ICU admission, mechanical ventilation, and in-hospital mortality. Results: Of the 815 patients registered, 439 (53.9%) developed AKI, 253 (57.6%) presented with AKI, and 186 (42.4%) developed AKI in-hospital. The odds of ICU admission, mechanical ventilation, and death increased as the AKI stage worsened. Stage 3 AKI that occurred during hospitalization increased the odds of death (odds ratio [OR] = 7.87 [4.35, 14.23]). Stage 3 AKI that occurred prior to hospitalization carried an increased odds of death (OR = 5.28 [2.60, 10.73]). Limitations: Observational study with small sample size limits precision of estimates. Lack of nonhospitalized patients with COVID-19 and hospitalized patients without COVID-19 as controls limits causal inferences. Conclusions: Acute kidney injury, whether it occurs prior to or after hospitalization, is associated with a high risk of poor outcomes in patients with COVID-19. Routine assessment of kidney function in patients with COVID-19 may improve risk stratification. Trial registration: The study was not registered on a publicly accessible registry because it did not involve any health care intervention on human participants.

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“…In both hospitalized adults and children, SARS-CoV2 infections are associated with high rates of acute kidney injury (AKI) [ 3 , 15 , 16 ]. Despite initial reports of limited kidney involvement, now there is a plethora of literature describing adult patients with AKI as an important complication in those hospitalized with SARS-CoV2 infection [ 15 , 16 ].…”

Section: Kidney-specific Sars-cov2 Clinical Manifestationsmentioning

confidence: 99%

Kidney implications of SARS-CoV2 infection in children

et al. 2021

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Research indicates that severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection can impact every organ, and the effects can range from asymptomatic to severe disease. Since it was first discovered in December 2019, our understanding has grown about its impact on kidney disease. In general, children have less severe disease than adults, and this tendency appears to extend to special pediatric kidney populations (e.g., chronic kidney disease and immunosuppressed patients with solid organ transplants or nephrotic syndrome). However, in a fraction of infected children, SARS-CoV2 causes an array of kidney manifestations, ranging from acute kidney injury to thrombotic microangiopathy, with potential implications for increased risk of morbidity and mortality. Additional considerations surround the propensity for clotting extracorporeal circuits in children with SARS-CoV2 infection that are receiving kidney replacement therapy. This review provides an update on our current understanding of SARS-CoV2 for pediatric nephrologists and highlights knowledge gaps to be addressed by future research during this ongoing pandemic, particularly the social disparities magnified during this period.

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The Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study

Cited by 74 publications

References 33 publications

A validation study of UCSD-Mayo risk score in predicting hospital-acquired acute kidney injury in COVID-19 patients

A validation study of UCSD-Mayo risk score in predicting hospital-acquired acute kidney injury in COVID-19 patients

Incidence and Outcomes of Acute Kidney Injury in Patients Admitted to Hospital With COVID-19: A Retrospective Cohort Study

Kidney implications of SARS-CoV2 infection in children

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