AKI in Hospitalized Patients with COVID-19.
Acute Kidney Injury
/ epidemiology
Aged
Aged, 80 and over
COVID-19
/ complications
Female
Hematuria
/ etiology
Hospital Mortality
Hospitals, Private
/ statistics & numerical data
Hospitals, Urban
/ statistics & numerical data
Humans
Incidence
Inpatients
Leukocytes
Male
Middle Aged
New York City
/ epidemiology
Proteinuria
/ etiology
Renal Dialysis
Retrospective Studies
SARS-CoV-2
Treatment Outcome
Urine
/ cytology
COVID-19
acute renal failure
clinical nephrology
dialysis
Journal
Journal of the American Society of Nephrology : JASN
ISSN: 1533-3450
Titre abrégé: J Am Soc Nephrol
Pays: United States
ID NLM: 9013836
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
08
05
2020
accepted:
03
08
2020
pubmed:
5
9
2020
medline:
12
1
2021
entrez:
5
9
2020
Statut:
ppublish
Résumé
Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associated with worse outcomes. However, AKI among hospitalized patients with COVID-19 in the United States is not well described. 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. Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patients with AKI required dialysis. The proportions with stages 1, 2, or 3 AKI were 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. 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.
Sections du résumé
BACKGROUND
Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associated with worse outcomes. However, AKI among hospitalized patients with COVID-19 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 patients with AKI required dialysis. The proportions with stages 1, 2, or 3 AKI were 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.
Identifiants
pubmed: 32883700
pii: 00001751-202101000-00016
doi: 10.1681/ASN.2020050615
pmc: PMC7894657
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
151-160Investigateurs
Lili Chan
(L)
Kumardeep Chaudhary
(K)
Aparna Saha
(A)
Kinsuk Chauhan
(K)
Akhil Vaid
(A)
Shan Zhao
(S)
Ishan Paranjpe
(I)
Sulaiman Somani
(S)
Felix Richter
(F)
Riccardo Miotto
(R)
Anuradha Lala
(A)
Arash Kia
(A)
Prem Timsina
(P)
Li Li
(L)
Robert Freeman
(R)
Rong Chen
(R)
Jagat Narula
(J)
Allan C Just
(AC)
Carol Horowitz
(C)
Zahi Fayad
(Z)
Carlos Cordon-Cardo
(C)
Eric Schadt
(E)
Matthew A Levin
(MA)
David L Reich
(DL)
Valentin Fuster
(V)
Barbara Murphy
(B)
John C He
(JC)
Alexander W Charney
(AW)
Erwin P Böttinger
(EP)
Benjamin S Glicksberg
(BS)
Steven G Coca
(SG)
Girish N Nadkarni
(GN)
Commentaires et corrections
Type : UpdateOf
Type : CommentIn
Informations de copyright
Copyright © 2021 by the American Society of Nephrology.
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