Risk factors for AKI and mortality in COVID-19 in Western Mexico

Background: Acute kidney injury (AKI) in COVID-19 is associated with disease severity. The aim of this study was to identify risk factors associated with the development of AKI and its clinical impact, such as need for RRT and mortality. Methods: Retrospective cohort study of hospitalized adult patients COVID-19, with normal kidney function, from April to December 2020 in Western Mexico. Results: 882 patients (60.8% men) with a mean age of 58.9y were included. 342 (38.8%) had a prior diagnosis DM, 412 (46.7%) HTN, 161 (18.3%) obesity, 59 (6.7%) heart diseases, 25 (2.8%) neurological disease, 47 (5.3%) lung disease. 216 (24.5%) smoking history. 270 patients (30.6%) developed AKI, 95 (10.77%) KDIGO stage 1, 44 (4.98%) stage 2, and 84 (9.52%) stage 3. 59 patients required RRT (6.23%), and 111 patients (12.6%) mechanical ventilation. Overall mortality was 30.6% (270 patients). Risk factors for mortality were: DM, HTN, neurological disease, age > 65 y, need for MV, and MAP < 65 mmHg, hyperNa, increased D-dimer or decreased HCO3 at admission. Risk factors for AKI were: DM, HTN, heart disease, age > 65 y, need for MV, and MAP < 65 mmHg, hyperNa, increased D-dimer or decreased HCO3 at admission. Image shows risk factors, ORs with CI. Conclusions: A high incidence of AKI in the Mexican population compared to reports from other countries, with a significantly high risk for death.

Mortality in COVID-19 patients with CKD with and without kidney replacement therapy in Western Mexico

Background: COVID-19 is a new disease of pandemic proportions. Currently, there are no reports on clinical outcomes in patients with CKD with and without KRT in the Mexican population. Our aim was to describe the clinical outcomes in patients with CKD. Methods: Retrospective cohort study of hospitalized adult patients COVID-19 confirmed with RT-PCR, from April to December 2020 in a second-level hospital in Western Mexico. Information was obtained from medical records. Results: 1012 patients were included, of which 130 patients (12.8%) had CKD (65.3% men), with a mean age of 53.8 years, 43.8% with Diabetes Mellitus and 82.3% with Hypertension. 84 patients (64.6%) were on KRT, within which 47 patients were on hemodialysis, 31 on peritoneal dialysis and 6 with a kidney transplant. 46 patients had no KRT, in stages ranging from KDIGO 3b to 5. 78.4%. 14 patients (10.7%) required mechanical ventilation. In our study, mortality among patients with normal kidney function was 30.6%. Regarding patients with CKD, patients on hemodialysis had a mortality of 25.5% (OR 0.74, 95% CI 0.39-1.5), patients on peritoneal dialysis had a mortality of 54.8% (OR 2.75, 95% CI 1.33-5.66), patients with CKD and no KRT had a mortality of 43.5% (OR 1.74, 95% CI 1.15-3.17). Conclusions: In our population, an increased mortality was found in patients with CKD with and without KRT, highlighting the mortality of patients on PD.