SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution.
Acute Kidney Injury
/ epidemiology
Adolescent
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
COVID-19
/ complications
Child
Child, Preschool
Comorbidity
Confidence Intervals
Creatinine
/ blood
Global Health
/ statistics & numerical data
Hospital Mortality
Humans
Inpatients
/ statistics & numerical data
Middle Aged
Odds Ratio
Registries
/ statistics & numerical data
SARS-CoV-2
Severity of Illness Index
AKI
Age-spectrum
COVID-19
Hospitalization
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
11 02 2022
11 02 2022
Historique:
received:
17
08
2021
accepted:
18
01
2022
entrez:
11
2
2022
pubmed:
12
2
2022
medline:
19
2
2022
Statut:
epublish
Résumé
Hospitalized patients with SARS-CoV2 develop acute kidney injury (AKI) frequently, yet gaps remain in understanding why adults seem to have higher rates compared to children. Our objectives were to evaluate the epidemiology of SARS-CoV2-related AKI across the age spectrum and determine if known risk factors such as illness severity contribute to its pattern. Secondary analysis of ongoing prospective international cohort registry. AKI was defined by KDIGO-creatinine only criteria. Log-linear, logistic and generalized estimating equations assessed odds ratios (OR), risk differences (RD), and 95% confidence intervals (CIs) for AKI and mortality adjusting for sex, pre-existing comorbidities, race/ethnicity, illness severity, and clustering within centers. Sensitivity analyses assessed different baseline creatinine estimators. Overall, among 6874 hospitalized patients, 39.6% (n = 2719) developed AKI. There was a bimodal distribution of AKI by age with peaks in older age (≥60 years) and middle childhood (5-15 years), which persisted despite controlling for illness severity, pre-existing comorbidities, or different baseline creatinine estimators. For example, the adjusted OR of developing AKI among hospitalized patients with SARS-CoV2 was 2.74 (95% CI 1.66-4.56) for 10-15-year-olds compared to 30-35-year-olds and similarly was 2.31 (95% CI 1.71-3.12) for 70-75-year-olds, while adjusted OR dropped to 1.39 (95% CI 0.97-2.00) for 40-45-year-olds compared to 30-35-year-olds. SARS-CoV2-related AKI is common with a bimodal age distribution that is not fully explained by known risk factors or confounders. As the pandemic turns to disproportionately impacting younger individuals, this deserves further investigation as the presence of AKI and SARS-CoV2 infection increases hospital mortality risk.
Sections du résumé
BACKGROUND
Hospitalized patients with SARS-CoV2 develop acute kidney injury (AKI) frequently, yet gaps remain in understanding why adults seem to have higher rates compared to children. Our objectives were to evaluate the epidemiology of SARS-CoV2-related AKI across the age spectrum and determine if known risk factors such as illness severity contribute to its pattern.
METHODS
Secondary analysis of ongoing prospective international cohort registry. AKI was defined by KDIGO-creatinine only criteria. Log-linear, logistic and generalized estimating equations assessed odds ratios (OR), risk differences (RD), and 95% confidence intervals (CIs) for AKI and mortality adjusting for sex, pre-existing comorbidities, race/ethnicity, illness severity, and clustering within centers. Sensitivity analyses assessed different baseline creatinine estimators.
RESULTS
Overall, among 6874 hospitalized patients, 39.6% (n = 2719) developed AKI. There was a bimodal distribution of AKI by age with peaks in older age (≥60 years) and middle childhood (5-15 years), which persisted despite controlling for illness severity, pre-existing comorbidities, or different baseline creatinine estimators. For example, the adjusted OR of developing AKI among hospitalized patients with SARS-CoV2 was 2.74 (95% CI 1.66-4.56) for 10-15-year-olds compared to 30-35-year-olds and similarly was 2.31 (95% CI 1.71-3.12) for 70-75-year-olds, while adjusted OR dropped to 1.39 (95% CI 0.97-2.00) for 40-45-year-olds compared to 30-35-year-olds.
CONCLUSIONS
SARS-CoV2-related AKI is common with a bimodal age distribution that is not fully explained by known risk factors or confounders. As the pandemic turns to disproportionately impacting younger individuals, this deserves further investigation as the presence of AKI and SARS-CoV2 infection increases hospital mortality risk.
Identifiants
pubmed: 35144572
doi: 10.1186/s12882-022-02681-2
pii: 10.1186/s12882-022-02681-2
pmc: PMC8831033
doi:
Substances chimiques
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
63Investigateurs
Jean-Baptiste Mesland
(JB)
Pierre Henin
(P)
Hélène Petre
(H)
Isabelle Buelens
(I)
Anne-Catherine Gerard
(AC)
Philippe Clevenbergh
(P)
Rolando Claure-Del Granado
(RC)
Jose A Mercado
(JA)
Esdenka Vega-Terrazas
(E)
Maria F Iturricha-Caceres
(MF)
Dragana Markotić
(D)
Ivana Bošnjak
(I)
Oscar Y Gavidia
(OY)
Felipe Pachon
(F)
Yeimy A Sanchez
(YA)
Danijel Knežević
(D)
Tanja Kovacevic
(T)
Josko Markic
(J)
Tatjana Catipovic Ardalic
(TC)
Branka Polic
(B)
Ivo Ivić
(I)
Dominko Carev
(D)
Robert Glavinic
(R)
Mohamed El Kassas
(M)
Mohamed Badr
(M)
Ahmed Tawheed
(A)
Ahmed Tawheed
(A)
Hend Yahia
(H)
Dimitrios Kantas
(D)
Vasileios Koulouras
(V)
None Sierra-Hoffman
Fernando Valerio
(F)
Oscar Diaz
(O)
Jose Luis Ramos Coello
(JLR)
Guillermo Perez
(G)
Ana Karen Vallecillo Lizardo
(AKV)
Gabina María Reyes Guillen
(GMR)
Helin Archaga Soto
(HA)
Csaba Kopitkó
(C)
Ágnes Bencze
(Á)
István Méhész
(I)
Zsófia Gerendai
(Z)
Phaneendra Doddaga
(P)
Neethi Chandra
(N)
Girish Vadgaonkar
(G)
Rekha Ediga
(R)
Shilpa Basety
(S)
Shwetha Dammareddy
(S)
Phani Sreeharsha Kasumalla
(PS)
Umamaheswara Raju
(U)
Janaki Manduva
(J)
Naresh Kolakani
(N)
Shreeja Sripathi
(S)
Sheetal Chaitanya
(S)
Anusha Cherian
(A)
Sreejith Parameswaran
(S)
Magesh Parthiban
(M)
A Menu Priya
(A)
Chetak Basavaraja
(C)
Madhav Prabhu
(M)
Vishal Jakati
(V)
Puneet Rijhwani
(P)
Ashish Jain
(A)
Aviral Gupta
(A)
Ram Mohan Jaiswal
(RM)
Ambika Tyagi
(A)
Nimish Mathur
(N)
Mradul Kumar Daga
(MK)
Munisha Agarwal
(M)
Ishan Rohtagi
(I)
Sridhar Papani
(S)
Mahesh Kamuram
(M)
Kamlesh Kumar Agrawal
(KK)
Vijendra Baghel
(V)
Kirti Kumar Patel
(KK)
Surapaneni Krishna Mohan
(SK)
Ekambaram Jyothisree
(E)
Mukur Petrolwala
(M)
Bharat Ladva
(B)
Yuki Itagaki
(Y)
Akira Kodate
(A)
Reina Suzuki
(R)
Akira Kodate
(A)
Yuki Takahashi
(Y)
Koyo Moriki
(K)
Michihito Kyo
(M)
Hidenobu Shigemitsu
(H)
Yuka Mishima
(Y)
Nobuyuki Nosaka
(N)
Michio Nagashima
(M)
Abdulrahman Al-Fares
(A)
Rene Rodriguez-Gutierrez
(R)
Jose Gerardo Gonzalez-Gonzalez
(JG)
Alejandro Salcido-Montenegro
(A)
Adrian Camacho-Ortiz
(A)
Fatimah Hassan-Hanga
(F)
Hadiza Galadanci
(H)
Abubakar Shehu Gezawa
(AS)
Halima M S Kabara
(HMS)
Taiwo Gboluwaga Amole
(TG)
Halima Kabir
(H)
Dalha Gwarzo Haliru
(DG)
Abdullahi S Ibrahim
(AS)
Muhammad Sohaib Asghar
(MS)
Mashaal Syed
(M)
Syed Anosh Ali Naqvi
(SAA)
Sidra Ishaque
(S)
Ali Faisal Saleem
(AF)
Naveed Ur Rehman Siddiqui
(NUR)
Salima Sherali
(S)
Yasmin Hashwani
(Y)
Shafia Ishaque
(S)
Igor Borisovich Zabolotskikh
(IB)
Konstantin Dmitrievich Zybin
(KD)
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(SV)
Tatiana Sergeevna Musaeva
(TS)
Marwa Ridha Amer
(MR)
Mohammed Abdullah Bawazeer
(MA)
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(TI)
Eiad Kseibi
(E)
Abid Shahzad Butt
(AS)
Syed Moazzum Khurshid
(SM)
Muath Rabee
(M)
Mohammed Abujazar
(M)
Razan Alghunaim
(R)
Maal Abualkhair
(M)
Abeer Turki AlFirm
(AT)
Eiad Kseibi
(E)
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(SM)
Muath Rabee
(M)
Mohammed Abujazar
(M)
Razan Alghunaim
(R)
Razan K Alamoudi
(RK)
Hassan M AlSharif
(HM)
Sarah A Almazwaghi
(SA)
Mohammed S Elsakran
(MS)
Mohamed A Aid
(MA)
Mouaz A Darwich
(MA)
Omnia M Hagag
(OM)
Salah A Ali
(SA)
Alona Rocacorba
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Kathrine Supeña
(K)
Efren Ray Juane
(ER)
Jenalyn Medina
(J)
Jowany Baduria
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Mohammed A Almazyad
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(MI)
Jara M Macarambon
(JM)
Ahmad Abdullah Bukhari
(AA)
Hussain A Albahrani
(HA)
Kazi N Asfina
(KN)
Kaltham M Aldossary
(KM)
Ana Andrijevic
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(S)
Vladimir Carapic
(V)
Pedja Kovacevic
(P)
Predrag D Stevanovic
(PD)
Dejan S Stojakov
(DS)
Duska K Ignjatovic
(DK)
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(SC)
Marina M Bobos
(MM)
Irina B Nenadic
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(AJ)
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C P T Stephanie L Wachs
(CPTSL)
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(BS)
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(CPTSL)
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Informations de copyright
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