Article ; Online: Impact of hospital-acquired acute kidney injury on Covid-19 outcomes in patients with and without chronic kidney disease: a multicenter retrospective cohort study
Turkish journal of medical sciences
2021 Volume 51, Issue 3, Page(s) 947–961
Abstract: Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 ... the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group ... in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes ...
| Abstract | Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3–5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47–73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9–44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9–33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients. |
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| MeSH term(s) | Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Aged ; COVID-19/complications ; COVID-19/epidemiology ; Female ; Hospital Mortality/trends ; Humans ; Incidence ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Pandemics ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/epidemiology ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Survival Rate/trends | |||||
| Language | English | |||||
| Publishing date | 2021-06-28 | |||||
| Publishing country | Turkey | |||||
| Document type | Journal Article ; Multicenter Study | |||||
| ZDB-ID | 1183461-4 | |||||
| ISSN | 1303-6165 ; 1300-0144 | |||||
| ISSN (online) | 1303-6165 | |||||
| ISSN | 1300-0144 | |||||
| DOI | 10.3906/sag-2011-169 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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