ABSTRACT
Background: Acute kidney injury (AKI) can eventually progress into chronic kidney disease (CKD) and end-stage kidney disease (ESKD). COVID-19 is a multisystemic disorder that often causes AKI. The purpose of this study is to assess the frequency and association of clinical variables in patients who developed CKD and ESKD after COVID-19-related AKI. Method(s): We performed a one-year follow-up study with 182 survivor patients admitted to the ward and intensive care unit (ICU) with COVID-19 between April 2020 and March 2021 at Hospital Sao Paulo, Brazil. Patients aged >= 18 years with COVID-19 confirmed on RT-PCR were included. Patients with ESKD before hospitalization were excluded. AKI and CKD were defined according to the KDIGO criteria. We evaluated the frequency of AKI. After it, we compared some clinical variables and outcomes in two subgroups: CKD after CoV-AKI, and non-CKD after COVID-19. Univariate and multivariate analyses were performed. Result(s): 137 (75.3%) patients developed AKI. Of these, 56 (30.8%) needed kidney replacement terapy (KRT) in-hospital. There were higher frequencies of diabetes and hypertension with lower eGFR (84.2+/-24.9, 94.4+/-29.9 ml/min;p=0.08) and mean arterial pressure (74.9+/-9.6, 79.1+/-7.7 mmHg;p=0.03) at baseline in CKD after CoV-AKI group. Hypertension was independently associated with CKD in binary logistic regression [OR: 4.472, 95% CI:1356-13886;p=0.001]. We further observed that all patients who progressed to ESKD (n=7;3.9%) had non-dialytic CKD exacerbated by COVID-19 requiring KRT. Conclusion(s): Hypertension was the independent clinical factor associated with progression to CKD after COVID-19-related AKI. All patients who progressed to ESKD had CKD exacerbated by COVID-19 requiring KRT.