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COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort.
Jewell, Paul D; Bramham, Kate; Galloway, James; Post, Frank; Norton, Sam; Teo, James; Fisher, Richard; Saha, Rohit; Hutchings, Sam; Hopkins, Phil; Smith, Priscilla; Joslin, Jennifer; Jayawardene, Satish; Mackie, Sarah; Mudhaffer, Ali; Holloway, Amelia; Kibble, Henry; Akter, Mosammat; Zuckerman, Benjamin; Palmer, Kieran; Murphy, Ciara; Iatropoulou, Domniki; Sharpe, Claire C; Lioudaki, Eirini.
  • Jewell PD; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Bramham K; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Galloway J; Faculty of Life Sciences and Medicine, King's College London, London, UK.
  • Post F; Faculty of Life Sciences and Medicine, King's College London, London, UK.
  • Norton S; Centre for Rheumatic Disease, King's College London, London, UK.
  • Teo J; Faculty of Life Sciences and Medicine, King's College London, London, UK.
  • Fisher R; Department of Sexual Health and HIV, King's College Hospital NHS Foundation Trust, London, UK.
  • Saha R; Faculty of Life Sciences and Medicine, King's College London, London, UK.
  • Hutchings S; Department of Neurosciences, King's College Hospital NHS Foundation Trust, London, UK.
  • Hopkins P; Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Smith P; Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Joslin J; Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Jayawardene S; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Mackie S; Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Mudhaffer A; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Holloway A; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Kibble H; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Akter M; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Zuckerman B; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Palmer K; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Murphy C; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Iatropoulou D; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Sharpe CC; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
  • Lioudaki E; Renal Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
BMC Nephrol ; 22(1): 359, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1496153
ABSTRACT

BACKGROUND:

Acute kidney injury (AKI) is common among patients hospitalised with COVID-19 and associated with worse prognosis. The aim of this study was to investigate the epidemiology, risk factors and outcomes of AKI in patients with COVID-19 in a large UK tertiary centre.

METHODS:

We analysed data of consecutive adults admitted with a laboratory-confirmed diagnosis of COVID-19 across two sites of a hospital in London, UK, from 1st January to 13th May 2020.

RESULTS:

Of the 1248 inpatients included, 487 (39%) experienced AKI (51% stage 1, 13% stage 2, and 36% stage 3). The weekly AKI incidence rate gradually increased to peak at week 5 (3.12 cases/100 patient-days), before reducing to its nadir (0.83 cases/100 patient-days) at the end the study period (week 10). Among AKI survivors, 84.0% had recovered renal function to pre-admission levels before discharge and none required on-going renal replacement therapy (RRT). Pre-existing renal impairment [odds ratio (OR) 3.05, 95%CI 2.24-4,18; p <  0.0001], and inpatient diuretic use (OR 1.79, 95%CI 1.27-2.53; p <  0.005) were independently associated with a higher risk for AKI. AKI was a strong predictor of 30-day mortality with an increasing risk across AKI stages [adjusted hazard ratio (HR) 1.59 (95%CI 1.19-2.13) for stage 1; p < 0.005, 2.71(95%CI 1.82-4.05); p < 0.001for stage 2 and 2.99 (95%CI 2.17-4.11); p < 0.001for stage 3]. One third of AKI3 survivors (30.7%), had newly established renal impairment at 3 to 6 months.

CONCLUSIONS:

This large UK cohort demonstrated a high AKI incidence and was associated with increased mortality even at stage 1. Inpatient diuretic use was linked to a higher AKI risk. One third of survivors with AKI3 exhibited newly established renal impairment already at 3-6 months.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Renal Replacement Therapy / Acute Kidney Injury / COVID-19 Subject: Renal Replacement Therapy / Acute Kidney Injury / COVID-19 Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Language: English Journal: BMC Nephrol Clinical aspect: Etiology / Prediction / Prognosis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Renal Replacement Therapy / Acute Kidney Injury / COVID-19 Subject: Renal Replacement Therapy / Acute Kidney Injury / COVID-19 Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Language: English Journal: BMC Nephrol Clinical aspect: Etiology / Prediction / Prognosis Year: 2021
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