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AKI in hospitalized patients with COVID-19

  • Background: Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associatedwith worse outcomes. However, AKI among hospitalized patients with COVID19 in the United States is not well described. Methods: This retrospective, observational study involved a review of data from electronic health records of patients aged >= 18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality. Results: Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patientswith AKI required dialysis. The proportionswith stages 1, 2, or 3 AKIwere 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% hadBackground: Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associatedwith worse outcomes. However, AKI among hospitalized patients with COVID19 in the United States is not well described. Methods: This retrospective, observational study involved a review of data from electronic health records of patients aged >= 18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality. Results: Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patientswith AKI required dialysis. The proportionswith stages 1, 2, or 3 AKIwere 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% had leukocyturia. Independent predictors of severe AKI were CKD, men, and higher serum potassium at admission. In-hospital mortality was 50% among patients with AKI versus 8% among those without AKI (aOR, 9.2; 95% confidence interval, 7.5 to 11.3). Of survivors with AKI who were discharged, 35% had not recovered to baseline kidney function by the time of discharge. An additional 28 of 77 (36%) patients who had not recovered kidney function at discharge did so on posthospital follow-up. Conclusions: AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Of all patients with AKI, only 30% survived with recovery of kidney function by the time of discharge.show moreshow less

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Author details:Lili Chan, Kumardeep ChaudharyORCiD, Aparna Saha, Kinsuk ChauhanORCiD, Akhil Vaid, Shan Zhao, Ishan Paranjpe, Sulaiman SomaniORCiD, Felix RichterORCiD, Riccardo Miotto, Anuradha Lala, Arash KiaORCiD, Prem Timsina, Li LiORCiD, Robert FreemanORCiD, Rong Chen, Jagat Narula, Allan C. Just, Carol Horowitz, Zahi Fayad, Carlos Cordon-Cardo, Eric Schadt, Matthew A. Levin, David L. Reich, Valentin FusterORCiD, Barbara Murphy, John C. He, Alexander W. Charney, Erwin BöttingerGND, Benjamin GlicksbergORCiD, Steven G. CocaORCiD, Girish N. NadkarniORCiD
DOI:https://doi.org/10.1681/ASN.2020050615
ISSN:1046-6673
ISSN:1533-3450
Pubmed ID:https://pubmed.ncbi.nlm.nih.gov/32883700
Title of parent work (English):Journal of the American Society of Nephrology : JASN
Publisher:American Society of Nephrology
Place of publishing:Washington
Publication type:Article
Language:English
Date of first publication:2021/12/29
Publication year:2021
Creating corporation:Mt Sinai COVID Informatics Ct
Release date:2024/01/10
Tag:COVID-19; acute renal failure; clinical nephrology; dialysis
Volume:32
Issue:1
Number of pages:10
First page:151
Last Page:160
Organizational units:An-Institute / Hasso-Plattner-Institut für Digital Engineering gGmbH
DDC classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Peer review:Referiert
Publishing method:Open Access / Bronze Open-Access
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