tetano
Editor, Senior Moderator
J Clin Med
. 2020 Jun 3;9(6):E1718.
doi: 10.3390/jcm9061718.
Fatal Outcomes of COVID-19 in Patients With Severe Acute Kidney Injury
Jeong-Hoon Lim[SUP] 1 [/SUP], Sun-Hee Park[SUP] 1 [/SUP], Yena Jeon[SUP] 2 [/SUP], Jang-Hee Cho[SUP] 1 [/SUP], Hee-Yeon Jung[SUP] 1 [/SUP], Ji-Young Choi[SUP] 1 [/SUP], Chan-Duck Kim[SUP] 1 [/SUP], Yong-Hoon Lee[SUP] 3 [/SUP], Hyewon Seo[SUP] 3 [/SUP], Jaehee Lee[SUP] 3 [/SUP], Ki Tae Kwon[SUP] 4 [/SUP], Shin-Woo Kim[SUP] 4 [/SUP], Hyun-Ha Chang[SUP] 4 [/SUP], Yong-Lim Kim[SUP] 1 [/SUP]
Affiliations
Abstract
The outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severity. Medical data of hospitalized COVID-19 patients in two university-based hospitals during an outbreak in Daegu, South Korea, were retrospectively analyzed. AKI and its severity were defined according to the Acute Kidney Injury Network. Of the 164 hospitalized patients with COVID-19, 30 patients (18.3%) had AKI; 14, 4, and 12 patients had stage 1, 2, and 3, respectively. The median age was significantly higher in AKI patients than in non-AKI patients (75.5 vs. 67.0 years, p = 0.005). There were 17 deaths (56.7%) among AKI patients; 4 (28.6%), 1 (25.0%), and 12 (100.0%), respectively. In-hospital mortality was higher in AKI patients than in non-AKI patients (56.7% vs. 20.8%, p < 0.001). After adjusting for potential confounding factors, stage 3 AKI was associated with higher mortality than either non-AKI or stage 1 AKI (hazard ratio (HR) = 3.62 (95% confidence interval (CI) = 1.75-7.48), p = 0.001; HR = 15.65 (95% CI = 2.43-100.64), p = 0.004). Among the AKI patients, acute respiratory distress syndrome and low serum albumin on admission were considered independent risk factors for stage 3 AKI (both p < 0.05). Five patients with stage 3 AKI underwent dialysis and eventually died. In conclusion, COVID-19 patients with severe AKI had fatal outcomes.
Keywords: AKI severity; COVID-19; acute kidney injury; mortality; renal replacement therapy.
. 2020 Jun 3;9(6):E1718.
doi: 10.3390/jcm9061718.
Fatal Outcomes of COVID-19 in Patients With Severe Acute Kidney Injury
Jeong-Hoon Lim[SUP] 1 [/SUP], Sun-Hee Park[SUP] 1 [/SUP], Yena Jeon[SUP] 2 [/SUP], Jang-Hee Cho[SUP] 1 [/SUP], Hee-Yeon Jung[SUP] 1 [/SUP], Ji-Young Choi[SUP] 1 [/SUP], Chan-Duck Kim[SUP] 1 [/SUP], Yong-Hoon Lee[SUP] 3 [/SUP], Hyewon Seo[SUP] 3 [/SUP], Jaehee Lee[SUP] 3 [/SUP], Ki Tae Kwon[SUP] 4 [/SUP], Shin-Woo Kim[SUP] 4 [/SUP], Hyun-Ha Chang[SUP] 4 [/SUP], Yong-Lim Kim[SUP] 1 [/SUP]
Affiliations
- PMID: 32503180
- DOI: 10.3390/jcm9061718
Abstract
The outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severity. Medical data of hospitalized COVID-19 patients in two university-based hospitals during an outbreak in Daegu, South Korea, were retrospectively analyzed. AKI and its severity were defined according to the Acute Kidney Injury Network. Of the 164 hospitalized patients with COVID-19, 30 patients (18.3%) had AKI; 14, 4, and 12 patients had stage 1, 2, and 3, respectively. The median age was significantly higher in AKI patients than in non-AKI patients (75.5 vs. 67.0 years, p = 0.005). There were 17 deaths (56.7%) among AKI patients; 4 (28.6%), 1 (25.0%), and 12 (100.0%), respectively. In-hospital mortality was higher in AKI patients than in non-AKI patients (56.7% vs. 20.8%, p < 0.001). After adjusting for potential confounding factors, stage 3 AKI was associated with higher mortality than either non-AKI or stage 1 AKI (hazard ratio (HR) = 3.62 (95% confidence interval (CI) = 1.75-7.48), p = 0.001; HR = 15.65 (95% CI = 2.43-100.64), p = 0.004). Among the AKI patients, acute respiratory distress syndrome and low serum albumin on admission were considered independent risk factors for stage 3 AKI (both p < 0.05). Five patients with stage 3 AKI underwent dialysis and eventually died. In conclusion, COVID-19 patients with severe AKI had fatal outcomes.
Keywords: AKI severity; COVID-19; acute kidney injury; mortality; renal replacement therapy.