Risk Factors for AKI in Patients With COVID-19 in Two University Hospital of Colombia

ABSTRACT

Background: Patients with COVID-19 have a high incidence of acute kidney injury (AKI), which is associated with mortality. The objetive of our study is to know the factors associated with AKI, to manage the level of care and health resources according to risk. Method(s) We design an observational retrospective cohort study in 2 hospitals in Bogota, Colombia. Adults hospitalized for > 48 hours between March 2020 and March 2021, with confirmed SARS-CoV-2 infection. The main outcome was incidence of AKI during the first 28 days from admission. A descriptive analysis of the sociodemographic and clinical characteristics of the study population was performed. Univariate and bivariate analysis and multivariate logistic regression model was conducted for the outcome AKI. Result(s) We included 1584 patients, 60.4% male, 46.8% older than 65 years. The incidence of AKI was 46.5%, stage 1 in 60.7%, Stage 2 in 15.7%, and stage 3 in 23.6%. Renal replacement therapy was performed in 11.1% of patients with AKI. Table 1 summarizes cohort characteristics and the bivariate analysis. In the multivariate analysis, sex, age, hypertension, CKD, treatment with oral antidiabetics, diuretics, statins, qSOFA, platelet count, CRP, D-dimer, treatment with vancomycin, piperacillin tazobactam, requirement of vasopressor support were realated with AKI. The interactions antihypertensive /diuretics, PAFI /Requirement of invasive mechanical ventilation, Hypertension /antihypertensives, were associated with AKI (P value <0.5). Hospital crude mortality for AKI was 45.5% versus 11.7% without AKI (p<0.0001) Conclusion(s) AKI is frequent in patients hospitalized with COVID 19, conventional risk factors are the rule, we denote other known markers of severity for COVID-19 in association with AKI. These results allowed us to manage the hospital resource.