Acute kidney injury in patients hospitalized with COVID-19 from the ISARIC WHO CCP-UK Study: a prospective, multicentre cohort study.
Nephrol Dial Transplant
; 37(2): 271-284, 2022 01 25.
Article
in English
| MEDLINE | ID: covidwho-1648225
ABSTRACT
BACKGROUND:
Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19). This study investigated adults hospitalized with COVID-19 and hypothesized that risk factors for AKI would include comorbidities and non-White race.METHODS:
A prospective multicentre cohort study was performed using patients admitted to 254 UK hospitals with COVID-19 between 17 January 2020 and 5 December 2020.RESULTS:
Of 85 687 patients, 2198 (2.6%) received acute kidney replacement therapy (KRT). Of 41 294 patients with biochemistry data, 13 000 (31.5%) had biochemical AKI 8562 stage 1 (65.9%), 2609 stage 2 (20.1%) and 1829 stage 3 (14.1%). The main risk factors for KRT were chronic kidney disease (CKD) [adjusted odds ratio (aOR) 3.41 95% confidence interval 3.06-3.81], male sex (aOR 2.43 2.18-2.71) and Black race (aOR 2.17 1.79-2.63). The main risk factors for biochemical AKI were admission respiratory rate >30 breaths per minute (aOR 1.68 1.56-1.81), CKD (aOR 1.66 1.57-1.76) and Black race (aOR 1.44 1.28-1.61). There was a gradated rise in the risk of 28-day mortality by increasing severity of AKI stage 1 aOR 1.58 (1.49-1.67), stage 2 aOR 2.41 (2.20-2.64), stage 3 aOR 3.50 (3.14-3.91) and KRT aOR 3.06 (2.75-3.39). AKI rates peaked in April 2020 and the subsequent fall in rates could not be explained by the use of dexamethasone or remdesivir.CONCLUSIONS:
AKI is common in adults hospitalized with COVID-19 and it is associated with a heightened risk of mortality. Although the rates of AKI have fallen from the early months of the pandemic, high-risk patients should have their kidney function and fluid status monitored closely.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Acute Kidney Injury
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
Journal:
Nephrol Dial Transplant
Journal subject:
Nephrology
/
Transplantation
Year:
2022
Document Type:
Article
Affiliation country:
Ndt
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