Single-center experience of AKI in COVID-19-infected patients in West Kent Hospital, United Kingdom

ABSTRACT

Background: The outcome of renal function and in COVID-19 positive patients is unclear. We studied the epidemiology of acute kidney injury (AKI) in the COVID-19 positive patients Methods: Between 9th March 2020 and 26th April 2020 data was prospectively collected on 253 adult COVID-19 positive inpatients about co-morbidity, s. creatinine, demographics and AKI from digital records at our secondary care hospital. AKI stages were defined as per KDIGO Criteria Results: Of the 253 patients, 58.9% were male with (mean ± stdev) age 71.9 ± 16.4 years. Common co-morbidities were Hypertension (54.1%), Cardiovascular Disease (34%), Diabetes Mellitus (28.3%), Chronic lung disease (23.3%), Dementia (20.5%), CKD (stage 3 - 5) 19.8% & 2 (0.8%) renal transplant. 2.8% (7) Patients on regular dialysis were excluded. 42.6% (105) patients had AKI. Of these 53.3% (56) had AKI 1, 20.9% (22) AKI 2 and 25.7% (25) had AKI 3. 2.4% (6) patient's needed acute haemofiltrated. The mean systolic BP at admission in non-AKI patients was 136 ± 22 mmHg (109 of 147 available) whilst in those with AKI it was 124 ± 25 mmHg (78 of 105 available). Thes, creatinine (median and range) in AKI patient at admission, peak and discharge or death was 126 (Range 30 - 1339), 173 (57 - 1339) and 113 (28 - 761) umol/L respectively. 52.4% (55) patients had recovered from AKI. The overall mortality rate in COVID-19 infected patient was 36.4% with mean age of 77.5 ± 12.4 years. Mortality in patients without AKI was 22% (31) & with AKI was 56.2% (59) with mean age of 77.7 ± 11.7 Years. The stagewise AKI mortality was AKI1 25.7% (27), AKI2 10.4% (11) and AKI3 20% (21). 66.6% haemofiltration patients. 23% (25) AKI patients died with normal creatinine. Mortality in CKD patients as co-morbidity was 64%. All renal transplant patients survived without having AKI. 7.7% {19} patients required continuous positive airway pressure, 42.1% (8) patients developed AKI of these 75% (6) patients with CPAP died. A further 24 (9.75%) required mechanical ventilation with 62.5% (15) of these developed AKI with mortality of 80% (12). Conclusions: Elderly patients were most commonly infected with COVID-19 infection. AKI was seen in 42.6% patients with COVID-19 infection. More than 60% COVID-19 infected patients died if they had AKI and were on any form of mechanical ventilatory support or had CKD as co-morbidity.