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Article ; Online: Incidence, risk factors and outcome of acute kidney injury (AKI) in patients with COVID-19.

2021 Volume 25, Issue 11, Page(s) 1203–1214

Abstract: ... Risk factors for kidney injury were age, male sex, CKD and higher non-renal SOFA score. Patients with AKI had ... 19). This study aims to evaluate incidence, risk factors and case-fatality rate of AKI in patients ... of inflammation and higher rate of severe pneumonia than non-AKI patients. Kidney injury was associated ...

Abstract	Background: Acute kidney injury (AKI) is a severe complication of coronavirus disease-2019 (COVID-19). This study aims to evaluate incidence, risk factors and case-fatality rate of AKI in patients with COVID-19. Methods: We reviewed the health medical records of 307 consecutive patients with COVID-19 hospitalized at the University Hospital of Modena, Italy. Results: AKI was diagnosed in 69 out of 307 (22.4%) COVID-19 patients. Stages 1, 2, or 3 AKI accounted for 57.9%, 24.6% and 17.3%, respectively. AKI patients had a mean age of 74.7 ± 9.9 years. These patients showed higher serum levels of the main markers of inflammation and higher rate of severe pneumonia than non-AKI patients. Kidney injury was associated with a higher rate of urinary abnormalities including proteinuria (0.44 ± 0.85 vs 0.18 ± 0.29 mg/mg; P = < 0.0001) and microscopic hematuria (P = 0.032) compared to non-AKI patients. Hemodialysis was performed in 7.2% of the subjects and 33.3% of the survivors did not recover kidney function after AKI. Risk factors for kidney injury were age, male sex, CKD and higher non-renal SOFA score. Patients with AKI had a mortality rate of 56.5%. Adjusted Cox regression analysis revealed that COVID-19-associated AKI was independently associated with in-hospital death (hazard ratio [HR] = 4.82; CI 95%, 1.36-17.08) compared to non-AKI patients. Conclusion: AKI was a common and harmful consequence of COVID-19. It manifested with urinary abnormalities (proteinuria, microscopic hematuria) and conferred an increased risk for death. Given the well-known short-term sequelae of AKI, prevention of kidney injury is imperative in this vulnerable cohort of patients.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/mortality ; Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/mortality ; Female ; Hematuria/epidemiology ; Humans ; Incidence ; Italy/epidemiology ; Male ; Middle Aged ; Prognosis ; Proteinuria/epidemiology ; Retrospective Studies ; Risk Assessment ; Risk Factors
Language	English
Publishing date	2021-07-01
Publishing country	Japan
Document type	Journal Article ; Observational Study
ZDB-ID	1338768-6
ISSN	1437-7799 ; 1342-1751
ISSN (online)	1437-7799
ISSN	1342-1751
DOI	10.1007/s10157-021-02092-x
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Article ; Online: Intracardiac Thrombus in COVID-19 Inpatients: A Nationwide Study of Incidence, Predictors, and Outcomes.

Agrawal, Ankit / Bajaj, Suryansh / Bhagat, Umesh / Chandna, Sanya / Arockiam, Aro Daniela / Chan, Nicholas / Haroun, Elio / Gupta, Rahul / Badwan, Osamah / Shekhar, Shashank / Kathavarayan Ramu, Shivabalan / Nayar, Divya / Jaber, Wael / Griffin, Brian P / Wang, Tom Kai Ming

Angiology

2024 , Page(s) 33197231225282

Abstract: ... We assessed the incidence, associated factors, and outcomes of COVID-19 patients with intracardiac thrombosis ... heart failure, 1.3% stroke, and 28.3% acute kidney injury (AKI). Key factors for intracardiac thrombosis were ... patients independently raised in-hospital mortality and morbidity risks. ...

Abstract	COronaVIrus Disease-2019 (COVID-19) is associated with a hypercoagulable state. Intracardiac thrombosis is a potentially serious complication but has seldom been evaluated in COVID-19 patients. We assessed the incidence, associated factors, and outcomes of COVID-19 patients with intracardiac thrombosis. In 2020, COVID-19 inpatients were identified from the National Inpatient Sample (NIS) database. Data on clinical characteristics, intracardiac thrombosis, and adverse outcomes were collected. Multivariable logistic regression was used to identify factors associated with intracardiac thrombosis, in-hospital mortality, and morbidities. In 2020, 1,683,785 COVID-19 inpatients (mean age 63.8 years, 32.2% females) were studied. Intracardiac thrombosis occurred in 0.10% (1830) of cases. In-hospital outcomes included 13.2% all-cause mortality, 3.5% cardiovascular mortality, 2.6% cardiac arrest, 4.4% acute coronary syndrome (ACS), 16.1% heart failure, 1.3% stroke, and 28.3% acute kidney injury (AKI). Key factors for intracardiac thrombosis were congestive heart failure history and coagulopathy. Intracardiac thrombosis independently linked to higher risks of all-cause mortality (odds ratio [OR]: 3.32 (2.42-4.54)), cardiovascular mortality (OR: 2.95 (1.96-4.44)), cardiac arrest (OR: 2.04 (1.22-3.43)), ACS (OR: 1.62 (1.17-2.22)), stroke (OR: 3.10 (2.11-4.56)), and AKI (OR: 2.13 (1.68-2.69)), but not heart failure. While rare, intracardiac thrombosis in COVID-19 patients independently raised in-hospital mortality and morbidity risks.
Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	80040-5
ISSN	1940-1574 ; 0003-3197
ISSN (online)	1940-1574
ISSN	0003-3197
DOI	10.1177/00033197231225282
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Article ; Online: Incidence of acute kidney injury (AKI) and outcomes in COVID-19 patients with and without antiviral medications: A retrospective study.

Mousavi Movahed, Seyed Majid / Akhavizadegan, Hamed / Dolatkhani, Fatemeh / Akbarpour, Samaneh / Nejadghaderi, Seyed Aria / Najafi, Morvarid / Pezeshki, Parmida Sadat / Khalili Noushabadi, Akram / Ghasemi, Hoomaan

PloS one

2023 Volume 18, Issue 10, Page(s) e0292746

Abstract: ... scarce. We aimed to determine the incidence of AKI and its outcomes in COVID-19 patients with and ... on the association between AKI and receiving antiviral agents with outcomes in hospitalized patients with COVID-19 is ... Background: Acute kidney injury is a complication of COVID-19 and is associated with severity ...

Abstract	Background: Acute kidney injury is a complication of COVID-19 and is associated with severity. Despite no specific antiviral treatment strategy, lopinavir/ritonavir and remdesivir have been used. Data on the association between AKI and receiving antiviral agents with outcomes in hospitalized patients with COVID-19 is scarce. We aimed to determine the incidence of AKI and its outcomes in COVID-19 patients with and without antiviral medications. Methods: We conducted a retrospective study on hospitalized adult patients with SARS-CoV-2 infection in a tertiary center. The primary endpoint was determining mortality, intensive care unit (ICU) admission, and length of hospitalization affected by AKI development using antiviral agents. The logistic regression method was used to explore the predictive effects of AKI and antiviral therapy on composite outcomes (i.e., mortality, ICU admission, and prolonged hospitalization) in four defined groups by AKI development/not and utilizing antivirals/not. We used IBM SPSS version 24.0 software for statistical analysis. Results: Out of 833 COVID-19 patients who were included, 75 patients were treated with antiviral agents and developed AKI. There was a significant difference in the occurrence of AKI and using antiviral medications (p = 0.001). Also, the group using antiviral agents and the development of AKI had the highest rate of preexisting hypertension (p = 0.002). Of note, the group of patients who used antiviral agents and also developed AKI had the most remarkable association with our composite outcome (p<0.0001), especially ICU admission (OR = 15.22; 95% CI: 8.06-27.32). Conclusions: The presence of AKI among COVID-19 patients treated with antiviral agents is linked to increased severity and mortality. Therefore, it is imperative to explore preventive measures for AKI development in patients receiving antiviral therapy. Larger-scale randomized controlled trials may be warranted to provide a more comprehensive understanding of these associations.
MeSH term(s)	Adult ; Humans ; COVID-19/complications ; COVID-19/epidemiology ; Retrospective Studies ; SARS-CoV-2 ; Incidence ; Intensive Care Units ; Antiviral Agents/adverse effects ; Acute Kidney Injury/chemically induced ; Acute Kidney Injury/epidemiology ; Risk Factors ; Hospital Mortality
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2023-10-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0292746
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Article ; Online: COVID-19 Associated Acute Kidney Injury: The Incidence and Associated Factors in Different KDIGO Stages Among the Hospitalized Patients.

Roozbeh, Jamshid / Hamidianjahromi, Anahid / Doostkam, Aida / Malekmakan, Leila / Dorraninejad, Abolfazl

Iranian journal of kidney diseases

2023 Volume 17, Issue 5, Page(s) 255–262

Abstract: ... patients with COVID-19 (mean age: 51.2 ± 16.2 years and men: 54.8%), of which 32.6% developed AKI during ... with COVID-19. In this study, we evaluated the frequency of AKI, the predisposing factors, and its impact ... P < .001).: Conclusions: Hospitalized patients with COVID-19 are vulnerable to AKI, especially ...

Abstract	Introduction: Acute kidney injury (AKI) is the most common reported renal complication associated with COVID-19. In this study, we evaluated the frequency of AKI, the predisposing factors, and its impact on the patient's outcomes in COVID-19. Methods: By collecting retrospective data, we conducted a crosssectional study on hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients in a COVID-19- designated hospital in Shiraz, Iran, from March 2020 to June 2020. Patients' characteristics and laboratory findings were recorded in data gathering sheets. Data were analyzed using SPSS Software Version 16. A P value < .05 was considered significant. Results: This study was conducted on 980 patients with COVID-19 (mean age: 51.2 ± 16.2 years and men: 54.8%), of which 32.6% developed AKI during their hospitalization period, and 1.3% ended up requiring renal replacement therapy. Patients with higher AKI stages experienced more severe/critical COVID-19 (stage 3: 71.0%, stage 2: 44.8%, stage 1: 6.5%; P < .001). The multivariate analysis showed that the proteinuria had the highest relationship with AKI (OR = 6.77 [95% CI: 4.39 to 10.41], P < .001), followed by in-hospital death (OR = 5.14 [95% CI: 1.86 to 14.47], P = .002). In addition, in-hospital death was more observed in higher stages of AKI (OR = 12.69 [95% CI: 3.85 to 42.09], P < .001). Conclusions: Hospitalized patients with COVID-19 are vulnerable to AKI, especially those who experienced more severe COVID-19 or require mechanical ventilation, which considerably affects the patients' mortality. The high incidence of AKI in our patients demonstrated that it should be considered as one of the common complications of COVID-19, and diagnostic measures, particularly in severe or critical cases, are recommended. DOI: 10.52547/ijkd.7636.
MeSH term(s)	Male ; Humans ; Adult ; Middle Aged ; Aged ; COVID-19/complications ; SARS-CoV-2 ; Retrospective Studies ; Incidence ; Hospital Mortality ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/diagnosis ; Risk Factors
Language	English
Publishing date	2023-10-14
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2388271-2
ISSN	1735-8604 ; 1735-8582
ISSN (online)	1735-8604
ISSN	1735-8582
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Article ; Online: Incidence of Chronic Kidney Disease Following Acute Coronavirus Disease 2019 Based on South Carolina Statewide Data.

Mathew, Roy O / Zhang, Jiajia / Yang, Xueying / Chen, Shujie / Olatosi, Bankole / Li, Xiaoming

Journal of general internal medicine

2023 Volume 38, Issue 8, Page(s) 1911–1919

Abstract: ... logistic regression and cox proportional hazards analyses.: Key results: Among patients with COVID-19 (N = 683,958 ... Define the incidence of new clinically identified chronic kidney disease (CKD) among patients with COVID ... 95%CI] 25.5-38.8), and intervening (between COVID-19 and CKD diagnoses) AKI diagnosis HR 20.7 (95%CI ...

Abstract	Background: Coronavirus disease 2019 (COVID-19) was associated with severe acute illness including multiple organ failure. Acute kidney injury (AKI) was a common finding, often requiring dialysis support. Objective: Define the incidence of new clinically identified chronic kidney disease (CKD) among patients with COVID-19 and no pre-existing kidney disease. Design participants: The South Carolina (SC) Department of Health and Environmental Control (DHEC) COVID-19 mandatory reporting registry of SC residents testing for COVID-19 between March 2020 and October 2021 was included. Design main measures: The primary outcome was a new incidence of a CKD diagnosis (N18.x) in those without a pre-existing diagnosis of CKD during the follow-up period of March 2020 to January 14, 2022. Patients were stratified by severity of illness (hospitalized or not, intensive care unit needed or not). The new incidence of CKD diagnosis was examined using logistic regression and cox proportional hazards analyses. Key results: Among patients with COVID-19 (N = 683,958) without a pre-existing CKD diagnosis, 8322 (1.2 %) were found to have a new diagnosis of CKD. The strongest predictors for subsequent CKD diagnosis were age ≥ 60 years hazard ratio (HR) 31.5 (95% confidence interval [95%CI] 25.5-38.8), and intervening (between COVID-19 and CKD diagnoses) AKI diagnosis HR 20.7 (95%CI 19.7-21.7). The presence of AKI was associated with an HR of 23.6, 95% CI 22.3-25.0, among those not hospitalized, and HR of 6.2, 95% CI 5.7-6.8 among those hospitalized, for subsequent CKD. COVID-19 was not significantly associated with subsequent CKD after accounting for the severity of illness and comorbidities. Conclusion: Among SC residents, COVID-19 was not associated with CKD independent from indicators of the severity of illness, especially AKI diagnosis. Kidney-specific follow-up testing may be reserved for those high-risk for CKD development. Further prospective registries should examine the long-term kidney consequences to confirm these findings.
MeSH term(s)	Humans ; Middle Aged ; COVID-19/complications ; COVID-19/epidemiology ; South Carolina/epidemiology ; Incidence ; COVID-19 Testing ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/complications ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Risk Factors ; Retrospective Studies
Language	English
Publishing date	2023-04-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-023-08184-6
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Article ; Online: Incidence of, and Risk Factors and Outcomes Associated with, Acute Kidney Injury in COVID-19 at the National Kidney and Transplant Institute, Philippines.

Altillero, Melchor / Danguilan, Romina / Arakama, Mel Hatra

Tropical medicine and infectious disease

2023 Volume 8, Issue 8

Abstract: 1) Background: Acute kidney injury (AKI) in COVID-19 leads to an increase in patient mortality ... dialysis and kidney-transplant patients were excluded. Kaplan-Meier survival analysis at 7, 14, and 30 days ... with renal outcomes. Patients were divided into diagnosed CKD, undiagnosed CKD, and normal eGFR. Chronic ...

Abstract	(1) Background: Acute kidney injury (AKI) in COVID-19 leads to an increase in patient mortality, especially among chronic kidney disease (CKD) patients. (2) Methods: A retrospective cohort of 519 adults admitted from 1 March 2020 to 1 March 2022 were reviewed for baseline characteristics and their association with renal outcomes. Patients were divided into diagnosed CKD, undiagnosed CKD, and normal eGFR. Chronic dialysis and kidney-transplant patients were excluded. Kaplan-Meier survival analysis at 7, 14, and 30 days from admission was performed. (3) Results: The overall incidence of AKI was 45.66%; the proportions among patients with diagnosed CKD, undiagnosed CKD, and normal eGFR were 76.64%, 38.75%, and 7.59%, respectively (
Language	English
Publishing date	2023-07-28
Publishing country	Switzerland
Document type	Journal Article
ISSN	2414-6366
ISSN (online)	2414-6366
DOI	10.3390/tropicalmed8080387
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Article: The Incidence of Acute Kidney Injury (AKI) in Critically Ill COVID-19 Patients: A Single-Center Retrospective Cohort Study at a Tertiary Level Hospital in Oman.

Al Abri, Sulaiman Y / Burad, Jyoti / Al Wahaibi, Mazin M

Cureus

2023 Volume 15, Issue 6, Page(s) e40340

Abstract: ... patients. Coronavirus disease 2019 (COVID-19) affects the renal system frequently and leads to AKI ... This study aims to determine the incidence of AKI, risk factors including hyperglycemia, and the requirement ... between March 2020 and September 2021. A total of 286 adult patients with laboratory-confirmed COVID-19 ...

Abstract	Background: Acute kidney injury (AKI) is associated with adverse outcomes in critically ill patients. Coronavirus disease 2019 (COVID-19) affects the renal system frequently and leads to AKI. This study aims to determine the incidence of AKI, risk factors including hyperglycemia, and the requirement for renal dialysis. Methods: A retrospectively observational study was done at Sultan Qaboos University Hospital between March 2020 and September 2021. A total of 286 adult patients with laboratory-confirmed COVID-19 infection admitted to the intensive care unit (ICU) were included in the study. The patient's medical records were reviewed. Patients' baseline demographic characteristics, APACHE score on admission, clinical data including length of stay, oxygenation parameters, ventilator days, shock, AKI (KIDIGO guideline), dialysis, medications, lab on admission as well as during the ICU stay, and the outcome (mortality) were recorded in detail. Follow-up was done till discharge from ICU. Results: The study population included 68.5% (196/286) males. The median age was 56 years (interquartile range, IQR: 43-66.25). The incidence of AKI was 55.2% (158/286) overall. Out of those who had AKI, 27.2% (43/158), 31.6% (50/158), and 41.1% (65/158) developed AKI stages 1, 2, and 3, respectively. Univariate analysis for the development of AKI showed the following significant variables: age (p=0.005; odds ratio, OR 1.024; 95% confidence interval, CI 1.007-1.041), creatinine level on admission (p=0.012; OR 1.005; 95%CI 1.001-1.008), APACHE score on admission (p<0.001; OR 1.049; 95%CI 1.021-1.077), P/F ratio (p<0.001; OR 0.991; 95%CI 0.987-0.995), nephrotoxic agent (p<0.001; OR 8.556; 95%CI 4.733-15.467), shock (p<0.001; OR 8.690; 95%CI 5.087-14.843), days on the ventilator (p<0.001; OR 1.085; 95%CI 1.043-1.129), and length of stay in ICU (p<0.001; OR 1.082; 95%CI 1.047-1.119). The multivariate analysis confirmed only shock (p=0.004; OR 5.893; 95%CI 1.766-19.664). A total of 41.7% (66/158) of patients received dialysis. Hyperglycemia was not associated with the development of AKI. For patients with AKI, those having high APACHE score (p<0.001), shock (p=0.56; OR 2.326; 95%CI 1.036-5.223), ischemic heart disease (IHD) (p=0.002; OR 9.000; 95%CI 1.923-42.130), and hypertension (p=0.023; OR 2.145; 95%CI 11.125-4.090) were significantly associated with the requirement of dialysis. The mortality was found to be 59.1% (169/286) overall whereas it was 83.5% (132/158) for AKI versus 28.9% (37/158) for non-AKI cases. Conclusions: A high incidence of AKI for critically ill COVID-19 cases was found in this study. The shock was the only significant predictor for the development of AKI. AKI is associated with high mortality in these patients.
Language	English
Publishing date	2023-06-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.40340
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Article: Incidence, risk factors and outcomes of acute kidney injury among COVID-19 patients: A systematic review of systematic reviews.

Mallhi, Tauqeer Hussain / Khan, Yusra Habib / Alzarea, Abdulaziz Ibrahim / Khan, Faiz Ullah / Alotaibi, Nasser Hadal / Alanazi, Abdullah Salah / Butt, Muhammad Hammad / Alatawi, Ahmed D / Salman, Muhammad / Alzarea, Sami I / Almalki, Ziyad Saeed / Alghazi, Mansoor A / Algarni, Majed Ahmed

Frontiers in medicine

2022 Volume 9, Page(s) 973030

Abstract: ... of acute kidney injury (AKI) was found independent predictor of death, where mortality rate among CAKI patients ranged ... The COVID-19 associated acute kidney injury (CAKI) has emerged as a potential intricacy during ... 4% in overall COVID-19 patients, and 39% among those having CAKI. The occurrence ...

Abstract	The COVID-19 associated acute kidney injury (CAKI) has emerged as a potential intricacy during the management of patients. Navigating the rapidly growing body of scientific literature on CAKI is challenging, and ongoing critical appraisal of this complication is essential. This study aimed to summarize and critically appraise the systematic reviews (SRs) on CAKI to inform the healthcare providers about its prevalence, risk factors and outcomes. All the SRs were searched in major databases (PubMed, EMBASE, Web of Science) from inception date to December 2021. This study followed SR of SRs methodology, all the records were screened, extracted and subjected to quality assessment by assessing the methodological quality of systematic reviews (AMSTAR-2). The extracted data were qualitatively synthesized and tabulated. This review protocol was registered in PROSPERO (CRD42022299444). Of 3,833 records identified; 42 SRs were included in this overview. The quality appraisal of the studies showed that 17 SRs were of low quality, while 8 moderate and 17 were of high-quality SRs. The incidence of CAKI ranged from 4.3% to 36.4% in overall COVID-19 patients, 36%-50% in kidney transplant recipients (KTRs), and up to 53% in severe or critical illness. Old age, male gender, cardiovascular disease, chronic kidney disease, diabetes mellitus and hypertension were frequently reported risk factors of CAKI. The need of renal replacement therapy (RRT) was up to 26.4% in overall COVID-19 patients, and 39% among those having CAKI. The occurrence of acute kidney injury (AKI) was found independent predictor of death, where mortality rate among CAKI patients ranged from 50% to 93%. This overview of SRs underscores that CAKI occurs frequently among COVID-19 patients and associated with high mortality, need of RRT and adverse outcomes. However, the confidence of these results is moderate to low which warrants the need of more SRs having established methodological standards. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299444], identifier [CRD42022299444].
Language	English
Publishing date	2022-11-04
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.973030
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Article ; Online: Effect of COVID-19 on Kidney Disease Incidence and Management.

McAdams, Meredith / Ostrosky-Frid, Mauricio / Rajora, Nilum / Hedayati, Susan

Kidney360

2020 Volume 2, Issue 1, Page(s) 141–153

Abstract: ... AKI incidence in patients with COVID-19, but more recent studies from North America reveal a much ... available evidence regarding the effect of COVID-19 on the incidence and management of kidney ... The COVID-19 outbreak has had substantial effects on the incidence and management ...

Abstract	The COVID-19 outbreak has had substantial effects on the incidence and management of kidney diseases, including AKI, ESKD, GN, and kidney transplantation. Initial reports from China suggested a lower AKI incidence in patients with COVID-19, but more recent studies from North America reveal a much higher incidence, likely due to the higher prevalence of comorbid conditions, such as hypertension, diabetes, and CKD. AKI in this setting is associated with worse outcomes, including the requirement for vasopressors or mechanical ventilation and death. Performing RRT in those with AKI poses challenges, such as limiting exposure of staff, preserving PPE, coagulopathy, and hypoxemia due to acute respiratory distress syndrome. Continuous RRT is the preferred modality, with sustained low-efficiency dialysis also an option, both managed without 1:1 hemodialysis nursing support. Regional citrate is the preferred anticoagulation, but systemic unfractionated heparin may be used in patients with coagulopathy. The ultrafiltration rate has to be set carefully, taking into consideration hypotension, hypoxemia, and responsiveness to presser and ventilatory support. The chance of transmission puts in-center chronic hemodialysis and other immunosuppressed patients at particularly increased risk. Limited data show that patients with CKD are also at increased risk for more severe disease, if infected. Little is known about the virus's effects on immunocompromised patients with glomerular diseases and kidney transplants, which introduces challenges for management of immunosuppressant regimens. Although there are no standardized guidelines regarding the management of immunosuppression, several groups recommend stopping the antimetabolite in hospitalized transplant patients and continuing a reduced dose of calcineurin inhibitors. This comprehensive review critically appraises the best available evidence regarding the effect of COVID-19 on the incidence and management of kidney diseases. Where evidence is lacking, current expert opinion and clinical guidelines are reviewed, and knowledge gaps worth investigation are identified.
MeSH term(s)	Acute Kidney Injury/epidemiology ; COVID-19/epidemiology ; Heparin ; Humans ; Incidence ; Kidney ; Risk Factors
Chemical Substances	Heparin (9005-49-6)
Language	English
Publishing date	2020-11-24
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2641-7650
ISSN (online)	2641-7650
DOI	10.34067/KID.0006362020
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Article: Study of Incidence, Clinical profile and Outcomes among patients hospitalized for COVID-19 with Acute Kidney Injury.

Burgula, Harsha / Mohanty, L / Mohanty, Ap / Khujur, Shiny T / Chaitanya, Annam / Devasi, Manoharlal

The Journal of the Association of Physicians of India

2022 Volume 70, Issue 4, Page(s) 11–12

Abstract: ... in association with COVID-19. The current study aims to highlight the incidence of acute kidney injury (AKI ... in COVID-19 patients, as well as the clinical profile and outcomes in that subset of patients ... and 26 (36.6%), respectively. 22 (32%) patients with AKI required dialysis. About 42(58.33%) patients ...

Abstract	The ongoing COVID-19 pandemic has thrown newer challenges for the health care professionals to manage the affected patients. Though the so called second wave is in a declining trend at present but possible third wave is looming in the near future. Initially patients appeared to have a respiratory limited disease but there are now increasing reports of multiple organ involvement including renal disease in association with COVID-19. The current study aims to highlight the incidence of acute kidney injury (AKI) in COVID-19 patients, as well as the clinical profile and outcomes in that subset of patients in a tertiary hospital setting, in order to better understand the role renal disease plays in the disease process. Material: Methods: This retrospective, observational study involved a review of data from electronic health records of patients aged more than 18 years with laboratory confirmed COVID-19 admitted to our hospital from February 27 to May 30, 2021. Data was analysed using SPSS version-21.0 by descriptive statistics. We describe the incidence of AKI, dialysis requirement, requirement of mechanical ventilation and mortality. Observation: Results of 400 hospitalized patients with COVID-19, 252(63%) were male, 148(37%) were female. AKI occurred in 72 (18%) patients. The proportions with stages 1, 2, or 3 AKI were 35(48.3%), 11 (15.1%), and 26 (36.6%), respectively. 22 (32%) patients with AKI required dialysis. About 42(58.33%) patients with AKI were admitted in Intensive care Unit and 35(48%) patients with AKI required mechanical ventilation. In-hospital mortality was (25%) among patients with AKI versus (7.01%) among those without AKI (OR, 4.42; 95% confidence interval, 2.23 to 8.73). Conclusion: Conclusions AKI is common among patients hospitalized with COVID-19 and is associated with high morbidity and mortality.
MeSH term(s)	Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; COVID-19/epidemiology ; Female ; Hospital Mortality ; Humans ; Incidence ; Male ; Observational Studies as Topic ; Pandemics ; Retrospective Studies ; Risk Factors ; SARS-CoV-2
Language	English
Publishing date	2022-04-20
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	800766-4
ISSN	0004-5772
ISSN	0004-5772
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