COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort
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 analy...
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2021
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oai:doaj.org-article:71d91db81df44aa9aa730f6ff43cf3222021-11-08T11:18:12ZCOVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort10.1186/s12882-021-02557-x1471-2369https://doaj.org/article/71d91db81df44aa9aa730f6ff43cf3222021-11-01T00:00:00Zhttps://doi.org/10.1186/s12882-021-02557-xhttps://doaj.org/toc/1471-2369Abstract 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.Paul D. JewellKate BramhamJames GallowayFrank PostSam NortonJames TeoRichard FisherRohit SahaSam HutchingsPhil HopkinsPriscilla SmithJennifer JoslinSatish JayawardeneSarah MackieAli MudhafferAmelia HollowayHenry KibbleMosammat AkterBenjamin ZuckermanKieran PalmerCiara MurphyDomniki IatropoulouClaire C. SharpeEirini LioudakiBMCarticleCOVID-19AKIMortalityRenal replacement therapyDiseases of the genitourinary system. UrologyRC870-923ENBMC Nephrology, Vol 22, Iss 1, Pp 1-12 (2021) |
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DOAJ |
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DOAJ |
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EN |
| topic |
COVID-19 AKI Mortality Renal replacement therapy Diseases of the genitourinary system. Urology RC870-923 |
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COVID-19 AKI Mortality Renal replacement therapy Diseases of the genitourinary system. Urology RC870-923 Paul D. Jewell Kate Bramham James Galloway Frank Post Sam Norton James Teo Richard Fisher Rohit Saha Sam Hutchings Phil Hopkins Priscilla Smith Jennifer Joslin Satish Jayawardene Sarah Mackie Ali Mudhaffer Amelia Holloway Henry Kibble Mosammat Akter Benjamin Zuckerman Kieran Palmer Ciara Murphy Domniki Iatropoulou Claire C. Sharpe Eirini Lioudaki COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort |
| description |
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. |
| format |
article |
| author |
Paul D. Jewell Kate Bramham James Galloway Frank Post Sam Norton James Teo Richard Fisher Rohit Saha Sam Hutchings Phil Hopkins Priscilla Smith Jennifer Joslin Satish Jayawardene Sarah Mackie Ali Mudhaffer Amelia Holloway Henry Kibble Mosammat Akter Benjamin Zuckerman Kieran Palmer Ciara Murphy Domniki Iatropoulou Claire C. Sharpe Eirini Lioudaki |
| author_facet |
Paul D. Jewell Kate Bramham James Galloway Frank Post Sam Norton James Teo Richard Fisher Rohit Saha Sam Hutchings Phil Hopkins Priscilla Smith Jennifer Joslin Satish Jayawardene Sarah Mackie Ali Mudhaffer Amelia Holloway Henry Kibble Mosammat Akter Benjamin Zuckerman Kieran Palmer Ciara Murphy Domniki Iatropoulou Claire C. Sharpe Eirini Lioudaki |
| author_sort |
Paul D. Jewell |
| title |
COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort |
| title_short |
COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort |
| title_full |
COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort |
| title_fullStr |
COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort |
| title_full_unstemmed |
COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort |
| title_sort |
covid-19-related acute kidney injury; incidence, risk factors and outcomes in a large uk cohort |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/71d91db81df44aa9aa730f6ff43cf322 |
| work_keys_str_mv |
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