COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort.
Acute Kidney Injury
/ diagnosis
COVID-19
/ complications
Cohort Studies
Hospital Mortality
Humans
Incidence
Intensive Care Units
/ statistics & numerical data
Kidney Function Tests
/ methods
Male
Middle Aged
Outcome and Process Assessment, Health Care
Patient Acuity
Renal Replacement Therapy
/ methods
Risk Factors
SARS-CoV-2
/ isolation & purification
Severity of Illness Index
United Kingdom
/ epidemiology
AKI
COVID-19
Mortality
Renal replacement therapy
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
received:
18
04
2021
accepted:
27
09
2021
entrez:
1
11
2021
pubmed:
2
11
2021
medline:
9
11
2021
Statut:
epublish
Résumé
Acute kidney injury (AKI) is common among patients hospitalised with COVID-19 and associated with worse prognosis. The aim of this study was to investigate the epidemiology, risk factors and outcomes of AKI in patients with COVID-19 in a large UK tertiary centre. We analysed data of consecutive adults admitted with a laboratory-confirmed diagnosis of COVID-19 across two sites of a hospital in London, UK, from 1st January to 13th May 2020. Of the 1248 inpatients included, 487 (39%) experienced AKI (51% stage 1, 13% stage 2, and 36% stage 3). The weekly AKI incidence rate gradually increased to peak at week 5 (3.12 cases/100 patient-days), before reducing to its nadir (0.83 cases/100 patient-days) at the end the study period (week 10). Among AKI survivors, 84.0% had recovered renal function to pre-admission levels before discharge and none required on-going renal replacement therapy (RRT). Pre-existing renal impairment [odds ratio (OR) 3.05, 95%CI 2.24-4,18; p < 0.0001], and inpatient diuretic use (OR 1.79, 95%CI 1.27-2.53; p < 0.005) were independently associated with a higher risk for AKI. AKI was a strong predictor of 30-day mortality with an increasing risk across AKI stages [adjusted hazard ratio (HR) 1.59 (95%CI 1.19-2.13) for stage 1; p < 0.005, 2.71(95%CI 1.82-4.05); p < 0.001for stage 2 and 2.99 (95%CI 2.17-4.11); p < 0.001for stage 3]. One third of AKI3 survivors (30.7%), had newly established renal impairment at 3 to 6 months. This large UK cohort demonstrated a high AKI incidence and was associated with increased mortality even at stage 1. Inpatient diuretic use was linked to a higher AKI risk. One third of survivors with AKI3 exhibited newly established renal impairment already at 3-6 months.
Sections du résumé
BACKGROUND
Acute kidney injury (AKI) is common among patients hospitalised with COVID-19 and associated with worse prognosis. The aim of this study was to investigate the epidemiology, risk factors and outcomes of AKI in patients with COVID-19 in a large UK tertiary centre.
METHODS
We analysed data of consecutive adults admitted with a laboratory-confirmed diagnosis of COVID-19 across two sites of a hospital in London, UK, from 1st January to 13th May 2020.
RESULTS
Of the 1248 inpatients included, 487 (39%) experienced AKI (51% stage 1, 13% stage 2, and 36% stage 3). The weekly AKI incidence rate gradually increased to peak at week 5 (3.12 cases/100 patient-days), before reducing to its nadir (0.83 cases/100 patient-days) at the end the study period (week 10). Among AKI survivors, 84.0% had recovered renal function to pre-admission levels before discharge and none required on-going renal replacement therapy (RRT). Pre-existing renal impairment [odds ratio (OR) 3.05, 95%CI 2.24-4,18; p < 0.0001], and inpatient diuretic use (OR 1.79, 95%CI 1.27-2.53; p < 0.005) were independently associated with a higher risk for AKI. AKI was a strong predictor of 30-day mortality with an increasing risk across AKI stages [adjusted hazard ratio (HR) 1.59 (95%CI 1.19-2.13) for stage 1; p < 0.005, 2.71(95%CI 1.82-4.05); p < 0.001for stage 2 and 2.99 (95%CI 2.17-4.11); p < 0.001for stage 3]. One third of AKI3 survivors (30.7%), had newly established renal impairment at 3 to 6 months.
CONCLUSIONS
This large UK cohort demonstrated a high AKI incidence and was associated with increased mortality even at stage 1. Inpatient diuretic use was linked to a higher AKI risk. One third of survivors with AKI3 exhibited newly established renal impairment already at 3-6 months.
Identifiants
pubmed: 34719384
doi: 10.1186/s12882-021-02557-x
pii: 10.1186/s12882-021-02557-x
pmc: PMC8557997
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
359Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2021. The Author(s).
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