The Frequency and Risk Factors for Acute Kidney Injury in patients with COVID-19

Abstract

Objective: To determine the frequency of Acute Kidney Injury (AKI) and its underlying risk factors in patients with Coronavirus Disease (COVID-19).
 Methods: This retrospective study was conducted by reviewing the medical records of patients admitted in Covid-19 Intensive Care Unit (ICU) of Farooq Hospital, West Wood Branch, Lahore during the period from 1st April, 2020 to 30th June, 2020. COVID-19 was diagnosed on basis of Real Time Polymerase Chain Reaction (RT-PCR) through nasal swab. Demographic, clinical and laboratory data were collected at the time of admission in the hospital. AKI was diagnosed on basis of ≥ 0.3 mg/dl increase in serum Creatinine (sCr) from baseline during the hospital stay. The outcome of study was AKI.
 Results: One hundred and seventy-six patients who fulfilled the inclusion criteria were recruited of which most were males (78.4%). The mean age was 51.26 ± 15.20 years and the frequency of AKI was 51.1%. The risk factors for AKI were increasing age (OR=2.10, p=0.017); presence of COVID-19 symptoms (OR=6.62, p=0.004); prolonged hospital stay (OR=2.26, p=0.011); Diabetes Mellitus (OR=1.81, p=0.057); hypoxemia (OR=5.98, p=0.000); leukocytosis (OR=2.91, p=0.002); lymphopenia (OR=5.77, p=0.000); hypoalbuminemia (OR=4.94, p=0.000); elevated C-reactive protein (CRP) (OR=6.20, p=0.000) and raised D-diamers (OR=3.16, p=0.000).
 Conclusions: AKI was present in half of the COVID-19 patients. The most significant risk factors for AKI were increasing age, prolonged hospital stay, hypoxemia, hypoalbuminemia, DM and raised inflammatory markers.
 doi: https://doi.org/10.12669/pjms.38.4.4980
 How to cite this:Anees M, Farooq O, Raza M, Mumtaz A. Frequency and Risk Factors for Acute Kidney Injury in patients with COVID-19. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4980
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Incidence, predictors and prognostic impact of acute kidney injury in patients with COVID-19

“…7 The overall mortality rate was 28.6% (58.2% in AKI vs. 9.4 in No-AKI group, p<0.001). The higher mortality rates in this particular study may be explained by the higher age (mean age 62.6 years) and higher burden of cardiovascular disease compared with the study of Anees et al 6 However, although the incidence and clinical predictors of AKI during acute phase of COVID-19, and impact on prognosis are now well-established, it is important to direct focus towards those patients who survive severe COVID-19 and develop post-acute sequelae. These are defined as signs and symptoms lasting beyond 30 days after initial infection with SARS-CoV-2 virus.…”

“…For comparison a large retrospective study from the US also explored the incidence and grade of AKI and impact on mortality in 1545 COVID-19 patients. 7 Of note, the definition of AKI and the exclusion criteria, which are major issues when comparing studies on AKI, were similar to those defined by Anees et al 6 (pregnancy and pre-existing chronic kidney disease). The authors found a 39% (n=608) incidence of AKI (294 [n=48.4%] with Grade-I, 185 [n=30.4%] Grade-II, and 129 [n=21.2%] Grade-III), and with a mortality rate of 58.2% (n=354).…”

“…3 Furthermore, recent studies have shown that COVID-19-induced AKI was associated with a greater percentage decline in estimated glomerular filtration rate (eGFR) 6-12 months after discharge compared with AKI patients without COVID-19. 3,5 In a recent edition of the journal, (Pak J Med Sci) Anees et al 6 , reported on the frequency and risk factors for AKI in COVID-19 patients admitted to ICU in Farooq Hospital, West Wood Branch, Lahore. The study was retrospective by design and included 176 patients (78.4% males and mean age 51.3 years).…”

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