Acute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort

Introduction: The incidence of acute kidney injury (AKI) in coronavirus disease 2019 (COVID-19) patients ranges from 0.5% to 35% and has been associated with worse prognosis. The purpose of this study was to evaluate the incidence, severity, duration, risk factors and prognosis of AKI in hospitalize...

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Autores principales:	Joana Gameiro, José Agapito Fonseca, João Oliveira, Filipe Marques, João Bernardo, Claudia Costa, Carolina Carreiro, Sandra Braz, José António Lopes
Formato:	article
Lenguaje:	ES
Publicado:	Elsevier 2021
Materias:	Lesión renal aguda COVID-19 Incidencia Mortalidad Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/7b81ee0c2b714c20afb1f2ba11cd4f70
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spelling	oai:doaj.org-article:7b81ee0c2b714c20afb1f2ba11cd4f702021-11-22T04:17:21ZAcute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort0211-699510.1016/j.nefro.2021.04.002https://doaj.org/article/7b81ee0c2b714c20afb1f2ba11cd4f702021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0211699521000977https://doaj.org/toc/0211-6995Introduction: The incidence of acute kidney injury (AKI) in coronavirus disease 2019 (COVID-19) patients ranges from 0.5% to 35% and has been associated with worse prognosis. The purpose of this study was to evaluate the incidence, severity, duration, risk factors and prognosis of AKI in hospitalized patients with COVID-19. Methods: We conducted a retrospective single-center analysis of 192 hospitalized COVID-19 patients from March to May of 2020. AKI was diagnosed using the Kidney Disease Improving Global Outcome (KDIGO) classification based on serum creatinine (SCr) criteria. Persistent and transient AKI were defined according to the Acute Disease Quality Initiative (ADQI) workgroup definitions. Results: In this cohort of COVID-19 patients, 55.2% developed AKI (n = 106). The majority of AKI patients had persistent AKI (n = 64, 60.4%). Overall, in-hospital mortality was 18.2% (n = 35) and was higher in AKI patients (28.3% vs. 5.9%, p < 0.001, unadjusted OR 6.03 (2.22–16.37), p < 0.001). In this multivariate analysis, older age (adjusted OR 1.07 (95% CI 1.02–1.11), p = 0.004), lower Hb level (adjusted OR 0.78 (95% CI 0.60–0.98), p = 0.035), duration of AKI (adjusted OR 7.34 for persistent AKI (95% CI 2.37–22.72), p = 0.001) and severity of AKI (adjusted OR 2.65 per increase in KDIGO stage (95% CI 1.32–5.33), p = 0.006) were independent predictors of mortality. Conclusion: AKI was frequent in hospitalized patients with COVID-19. Persistent AKI and higher severity of AKI were independent predictors of in-hospital mortality. Resumen: Introducción: La incidencia de lesión renal aguda (LRA) en pacientes con enfermedad por coronavirus 2019 (COVID-19) oscila entre el 0,5 y el 35% y se ha asociado a peor pronóstico. El propósito de este estudio fue evaluar la incidencia, gravedad, duración, factores de riesgo y pronóstico de la LRA en pacientes hospitalizados con COVID-19. Métodos: Realizamos un análisis retrospectivo de un solo centro de 192 pacientes con COVID-19 hospitalizados de marzo a mayo de 2020. La LRA se diagnosticó utilizando la clasificación Kidney Disease Improving Global Outcome (KDIGO) basada en criterios de creatinina sérica (SCr). La LRA persistente y la transitoria se definieron de acuerdo con las definiciones del grupo de trabajo de la Iniciativa de Calidad de Enfermedades Agudas (ADQI). Resultados: En esta cohorte de pacientes con COVID-19, el 55,2% desarrolló LRA (n = 106). La mayoría de los pacientes tenían LRA persistente (n = 64; 60,4%). En general, la mortalidad hospitalaria fue del 18,2% (n = 35) y fue mayor en los pacientes con LRA (28,3% frente a 5,9%; p < 0,001), (OR no ajustada 6,03; IC 95%: 2,22-16,37; p < 0,001). En este análisis multivariado, mayor edad (OR ajustada 1,07; IC 95%: 1,02-1,11; p = 0,004), menor nivel de Hb (OR ajustada 0,78; IC 95%: 0,60-0,98; p = 0,035), duración de la LRA (OR ajustada 7,34 para LRA persistente; IC 95%: 2,37-22,72; p = 0,001) y la gravedad de LRA (OR ajustada 2,65 por aumento en el estadio KDIGO; IC 95%: 1,32-5,33; p = 0,006) fueron predictores independientes de mortalidad. Conclusión: La LRA fue frecuente en pacientes hospitalizados con COVID-19. La LRA persistente y su mayor gravedad fueron predictores independientes de mortalidad hospitalaria.Joana GameiroJosé Agapito FonsecaJoão OliveiraFilipe MarquesJoão BernardoClaudia CostaCarolina CarreiroSandra BrazJosé António LopesElsevierarticleLesión renal agudaCOVID-19IncidenciaMortalidadDiseases of the genitourinary system. UrologyRC870-923ESNefrología, Vol 41, Iss 6, Pp 689-698 (2021)
institution	DOAJ
collection	DOAJ
language	ES
topic	Lesión renal aguda COVID-19 Incidencia Mortalidad Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Lesión renal aguda COVID-19 Incidencia Mortalidad Diseases of the genitourinary system. Urology RC870-923 Joana Gameiro José Agapito Fonseca João Oliveira Filipe Marques João Bernardo Claudia Costa Carolina Carreiro Sandra Braz José António Lopes Acute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort
description	Introduction: The incidence of acute kidney injury (AKI) in coronavirus disease 2019 (COVID-19) patients ranges from 0.5% to 35% and has been associated with worse prognosis. The purpose of this study was to evaluate the incidence, severity, duration, risk factors and prognosis of AKI in hospitalized patients with COVID-19. Methods: We conducted a retrospective single-center analysis of 192 hospitalized COVID-19 patients from March to May of 2020. AKI was diagnosed using the Kidney Disease Improving Global Outcome (KDIGO) classification based on serum creatinine (SCr) criteria. Persistent and transient AKI were defined according to the Acute Disease Quality Initiative (ADQI) workgroup definitions. Results: In this cohort of COVID-19 patients, 55.2% developed AKI (n = 106). The majority of AKI patients had persistent AKI (n = 64, 60.4%). Overall, in-hospital mortality was 18.2% (n = 35) and was higher in AKI patients (28.3% vs. 5.9%, p < 0.001, unadjusted OR 6.03 (2.22–16.37), p < 0.001). In this multivariate analysis, older age (adjusted OR 1.07 (95% CI 1.02–1.11), p = 0.004), lower Hb level (adjusted OR 0.78 (95% CI 0.60–0.98), p = 0.035), duration of AKI (adjusted OR 7.34 for persistent AKI (95% CI 2.37–22.72), p = 0.001) and severity of AKI (adjusted OR 2.65 per increase in KDIGO stage (95% CI 1.32–5.33), p = 0.006) were independent predictors of mortality. Conclusion: AKI was frequent in hospitalized patients with COVID-19. Persistent AKI and higher severity of AKI were independent predictors of in-hospital mortality. Resumen: Introducción: La incidencia de lesión renal aguda (LRA) en pacientes con enfermedad por coronavirus 2019 (COVID-19) oscila entre el 0,5 y el 35% y se ha asociado a peor pronóstico. El propósito de este estudio fue evaluar la incidencia, gravedad, duración, factores de riesgo y pronóstico de la LRA en pacientes hospitalizados con COVID-19. Métodos: Realizamos un análisis retrospectivo de un solo centro de 192 pacientes con COVID-19 hospitalizados de marzo a mayo de 2020. La LRA se diagnosticó utilizando la clasificación Kidney Disease Improving Global Outcome (KDIGO) basada en criterios de creatinina sérica (SCr). La LRA persistente y la transitoria se definieron de acuerdo con las definiciones del grupo de trabajo de la Iniciativa de Calidad de Enfermedades Agudas (ADQI). Resultados: En esta cohorte de pacientes con COVID-19, el 55,2% desarrolló LRA (n = 106). La mayoría de los pacientes tenían LRA persistente (n = 64; 60,4%). En general, la mortalidad hospitalaria fue del 18,2% (n = 35) y fue mayor en los pacientes con LRA (28,3% frente a 5,9%; p < 0,001), (OR no ajustada 6,03; IC 95%: 2,22-16,37; p < 0,001). En este análisis multivariado, mayor edad (OR ajustada 1,07; IC 95%: 1,02-1,11; p = 0,004), menor nivel de Hb (OR ajustada 0,78; IC 95%: 0,60-0,98; p = 0,035), duración de la LRA (OR ajustada 7,34 para LRA persistente; IC 95%: 2,37-22,72; p = 0,001) y la gravedad de LRA (OR ajustada 2,65 por aumento en el estadio KDIGO; IC 95%: 1,32-5,33; p = 0,006) fueron predictores independientes de mortalidad. Conclusión: La LRA fue frecuente en pacientes hospitalizados con COVID-19. La LRA persistente y su mayor gravedad fueron predictores independientes de mortalidad hospitalaria.
format	article
author	Joana Gameiro José Agapito Fonseca João Oliveira Filipe Marques João Bernardo Claudia Costa Carolina Carreiro Sandra Braz José António Lopes
author_facet	Joana Gameiro José Agapito Fonseca João Oliveira Filipe Marques João Bernardo Claudia Costa Carolina Carreiro Sandra Braz José António Lopes
author_sort	Joana Gameiro
title	Acute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort
title_short	Acute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort
title_full	Acute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort
title_fullStr	Acute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort
title_full_unstemmed	Acute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort
title_sort	acute kidney injury in hospitalized patients with covid-19: a portuguese cohort
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/7b81ee0c2b714c20afb1f2ba11cd4f70
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Acute kidney injury in hospitalized patients with COVID-19: A Portuguese cohort

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