tetano
Editor, Senior Moderator
J Clin Med
. 2021 Nov 25;10(23):5522.
doi: 10.3390/jcm10235522.
Kidney Dysfunction and Its Progression in Patients Hospitalized Duo to COVID-19: Contribution to the Clinical Course and Outcomes
Katarzyna Kilis-Pstrusinska[SUP] 1 [/SUP], Katarzyna Akutko[SUP] 2 [/SUP], Joanna Braksator[SUP] 2 [/SUP], Anna Dancewicz[SUP] 2 [/SUP], Patrycja Grosman-Dziewiszek[SUP] 3 [/SUP], Tatiana Jamer[SUP] 2 [/SUP], Katarzyna Juszczyńska[SUP] 4 [/SUP], Klaudia Konikowska[SUP] 5 [/SUP], Marta Koruba[SUP] 1 [/SUP], Małgorzata Pupek[SUP] 6 [/SUP], Agnieszka Rusiecka[SUP] 7 [/SUP], Krzysztof Kujawa[SUP] 7 [/SUP], Barbara Adamik[SUP] 8 [/SUP], Adrian Doroszko[SUP] 9 [/SUP], Krzysztof Kaliszewski[SUP] 10 [/SUP], Agnieszka Matera-Witkiewicz[SUP] 11 [/SUP], Michał Pomorski[SUP] 12 [/SUP], Marcin Protasiewicz[SUP] 13 [/SUP], Janusz Sokołowski[SUP] 14 [/SUP], Katarzyna Madziarska[SUP] 15 [/SUP], Ewa A Jankowska[SUP] 16 [/SUP]
Affiliations
Abstract
The disease caused by coronavirus SARS-CoV-2 (COVID-19) can affect almost all organs of the human body, including kidneys. We conducted a one-center study to comprehensively analyze the effects of kidney involvement on the course and outcomes in patients hospitalized with COVID-19, depending on the estimated glomerular filtration rate (eGFR) at admission. Out of the 1958 patients, 1342 (68.54%) had eGFR ≥ 60 mL/min/1.73 m[SUP]2[/SUP] (group A) and 616 (31.46%) had eGFR < 60 mL/min/1.73 m[SUP]2[/SUP] (group B). Group B was additionally divided into subgroups B1, B2, and B3 based on eGFR. We found that mortality rates during hospitalization, as well as after 90 and 180 days, were much higher in group B than group A. The highest mortality was observed in the B2 subgroup with eGFR of 15-29. The mortality of B patients was associated with comorbidities, respiratory dysfunction, immunological impairment, and more frequent development of AKI. AKI had a negative impact on patients' survival, regardless of the initial renal function. At discharge, 7.4% of patients had serum creatinine levels 30% higher, or more, as compared to admission. The disease course and outcomes in COVID-19 patients are associated with baseline eGFR; however, AKI during hospitalization is a more significant predictor of poor prognosis regardless of the initial renal function.
Keywords: COVID-19; acute kidney injury; hospitalization; kidney dysfunction; mortality.
. 2021 Nov 25;10(23):5522.
doi: 10.3390/jcm10235522.
Kidney Dysfunction and Its Progression in Patients Hospitalized Duo to COVID-19: Contribution to the Clinical Course and Outcomes
Katarzyna Kilis-Pstrusinska[SUP] 1 [/SUP], Katarzyna Akutko[SUP] 2 [/SUP], Joanna Braksator[SUP] 2 [/SUP], Anna Dancewicz[SUP] 2 [/SUP], Patrycja Grosman-Dziewiszek[SUP] 3 [/SUP], Tatiana Jamer[SUP] 2 [/SUP], Katarzyna Juszczyńska[SUP] 4 [/SUP], Klaudia Konikowska[SUP] 5 [/SUP], Marta Koruba[SUP] 1 [/SUP], Małgorzata Pupek[SUP] 6 [/SUP], Agnieszka Rusiecka[SUP] 7 [/SUP], Krzysztof Kujawa[SUP] 7 [/SUP], Barbara Adamik[SUP] 8 [/SUP], Adrian Doroszko[SUP] 9 [/SUP], Krzysztof Kaliszewski[SUP] 10 [/SUP], Agnieszka Matera-Witkiewicz[SUP] 11 [/SUP], Michał Pomorski[SUP] 12 [/SUP], Marcin Protasiewicz[SUP] 13 [/SUP], Janusz Sokołowski[SUP] 14 [/SUP], Katarzyna Madziarska[SUP] 15 [/SUP], Ewa A Jankowska[SUP] 16 [/SUP]
Affiliations
- PMID: 34884225
- DOI: 10.3390/jcm10235522
Abstract
The disease caused by coronavirus SARS-CoV-2 (COVID-19) can affect almost all organs of the human body, including kidneys. We conducted a one-center study to comprehensively analyze the effects of kidney involvement on the course and outcomes in patients hospitalized with COVID-19, depending on the estimated glomerular filtration rate (eGFR) at admission. Out of the 1958 patients, 1342 (68.54%) had eGFR ≥ 60 mL/min/1.73 m[SUP]2[/SUP] (group A) and 616 (31.46%) had eGFR < 60 mL/min/1.73 m[SUP]2[/SUP] (group B). Group B was additionally divided into subgroups B1, B2, and B3 based on eGFR. We found that mortality rates during hospitalization, as well as after 90 and 180 days, were much higher in group B than group A. The highest mortality was observed in the B2 subgroup with eGFR of 15-29. The mortality of B patients was associated with comorbidities, respiratory dysfunction, immunological impairment, and more frequent development of AKI. AKI had a negative impact on patients' survival, regardless of the initial renal function. At discharge, 7.4% of patients had serum creatinine levels 30% higher, or more, as compared to admission. The disease course and outcomes in COVID-19 patients are associated with baseline eGFR; however, AKI during hospitalization is a more significant predictor of poor prognosis regardless of the initial renal function.
Keywords: COVID-19; acute kidney injury; hospitalization; kidney dysfunction; mortality.