Covid and Kidney-Oea Friend or Foe

ABSTRACT

BACKGROUND: Covid-19 has been associated with worsened prognosis in patients with kidney involvement. The incidence of acute kidney injury (AKI) in Coronavirus-19 disease (COVID-19) patients ranges from 0.5% to 35%. AIM OF THE STUDY We evaluated the prevalence severity risk factors and prognosis in patients with COVID-19 having AKI or CKD. METHOD(S) We conducted a retrospective analysis of 70 patients with Covid-19 presenting to nephrology department. Outcome of patients with CKD stage 1-2 was compared with that of patients with AKI kidney transplant and CKD stage G3a-G5D. RESULT(S) In this study, 15 (21.4%) patients had CKD stage G1-2, 18 (25.71%) had CKD stage G3a-5c and 11 (15.7%) had CKD stage G5d. Eight patients (11.4%) were with functioning renal allograft (CKD-T). Four (5.71%) developed AKI and 14 patients (20%) had acute on CKD. Overall;in-hospital mortality was 27.14% (n = 19). Of these, 3 patients (15.78%) had CKD stage G1-G2, 7 (36.84%) had CKD stage G3a-5c, 3 had CKD G5D, 2 (10.55%) had acute on CKD, one had AKI and 3 patients had a functioning kidney allograft. Baseline & nadir serum creatinine & eGFR of CKD stage 1-2, CKD Stage 3a-5c and stage CKD-t was 0.87 (eGFR 82), 7.34 (eGFR 11.61), 3.24 (eGFR-24.86);and 0.74 (eGFR 93.55), 5.37 (eGFR 16.55) and 1.85 (eGFR 42.28) respectively. CONCLUSION(S) A rather low prevalence of AKI in our Covid-19 patients, lower mortality in acute on CKD patients & improvement in eGFR in CKD & transplant patient in our study suggest that coronavirus has minimal, if any direct toxic effect on kidney. But presence of renal failure worsens the outcome of Covid-19 disease.