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Outcomes Among Patients Hospitalized With COVID-19 and Acute Kidney Injury.
Ng, Jia H; Hirsch, Jamie S; Hazzan, Azzour; Wanchoo, Rimda; Shah, Hitesh H; Malieckal, Deepa A; Ross, Daniel W; Sharma, Purva; Sakhiya, Vipulbhai; Fishbane, Steven; Jhaveri, Kenar D.
  • Ng JH; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Hirsch JS; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY; Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY; Department of Information Services
  • Hazzan A; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Wanchoo R; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Shah HH; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Malieckal DA; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Ross DW; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Sharma P; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Sakhiya V; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Fishbane S; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY.
  • Jhaveri KD; Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY. Electronic address: kjhaveri@northwell.edu.
Am J Kidney Dis ; 77(2): 204-215.e1, 2021 02.
Article in English | MEDLINE | ID: covidwho-780043
ABSTRACT
RATIONALE &

OBJECTIVE:

Outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) are not well understood. The goal of this study was to investigate the survival and kidney outcomes of these patients. STUDY

DESIGN:

Retrospective cohort study. SETTING &

PARTICIPANTS:

Patients (aged≥18 years) hospitalized with COVID-19 at 13 hospitals in metropolitan New York between March 1, 2020, and April 27, 2020, followed up until hospital discharge. EXPOSURE AKI.

OUTCOMES:

Primary

outcome:

in-hospital death. SECONDARY

OUTCOMES:

requiring dialysis at discharge, recovery of kidney function. ANALYTICAL

APPROACH:

Univariable and multivariable time-to-event analysis and logistic regression.

RESULTS:

Among 9,657 patients admitted with COVID-19, the AKI incidence rate was 38.4/1,000 patient-days. Incidence rates of in-hospital death among patients without AKI, with AKI not requiring dialysis (AKI stages 1-3), and with AKI receiving dialysis (AKI 3D) were 10.8, 31.1, and 37.5/1,000 patient-days, respectively. Taking those without AKI as the reference group, we observed greater risks for in-hospital death for patients with AKI 1-3 and AKI 3D (HRs of 5.6 [95% CI, 5.0-6.3] and 11.3 [95% CI, 9.6-13.1], respectively). After adjusting for demographics, comorbid conditions, and illness severity, the risk for death remained higher among those with AKI 1-3 (adjusted HR, 3.4 [95% CI, 3.0-3.9]) and AKI 3D (adjusted HR, 6.4 [95% CI, 5.5-7.6]) compared with those without AKI. Among patients with AKI 1-3 who survived, 74.1% achieved kidney recovery by the time of discharge. Among those with AKI 3D who survived, 30.6% remained on dialysis at discharge, and prehospitalization chronic kidney disease was the only independent risk factor associated with needing dialysis at discharge (adjusted OR, 9.3 [95% CI, 2.3-37.8]).

LIMITATIONS:

Observational retrospective study, limited to the NY metropolitan area during the peak of the COVID-19 pandemic.

CONCLUSIONS:

AKI in hospitalized patients with COVID-19 was associated with significant risk for death.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Renal Dialysis / Hospital Mortality / Acute Kidney Injury / COVID-19 / Hospitalization Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Am J Kidney Dis Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renal Dialysis / Hospital Mortality / Acute Kidney Injury / COVID-19 / Hospitalization Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Am J Kidney Dis Year: 2021 Document Type: Article