Journal
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
Volume 15, Issue 10, Pages 1394-1402Publisher
AMER SOC NEPHROLOGY
DOI: 10.2215/CJN.04650420
Keywords
acute kidney injury; COVID-19; mortality; prognosis; risk factors
Categories
Funding
- NationalNatural Science Foundation of China
- Deutsche Forschungsgemeinschaft international (regional) cooperation and exchange projects [81761138041]
- National Natural Science Foundation ofChina grants [81570667, 81470948, 81670633]
- Major Research Plan of the National Natural Science Foundation of China [91742204]
- National Key Research and Development Program of China [2018YFC1314003-1, 2015BAI12B07]
- National Key Research and Development Program [2016YFC0906103]
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Backgroundandobjectives SinceDecember 2019, coronavirusdisease 2019(COVID-19) outbreak occurred and has rapidly spread worldwide. However, little information is available about the AKI in COVID-19. We aimed to evaluate the incidence, risk factors, and prognosis of AKI in adult patients with COVID-19. Design, setting, participants, & measurements This was a retrospective cohort study of 1392 patients with COVID-19 admitted to a tertiary teaching hospital. Clinical characteristics and laboratory data were extracted from electronic hospitalization and laboratory databases. AKI was defined and staged according to the 2012 Kidney Disease: Improving Global Outcomes criteria. Risk factors for AKI and the association of AKI with in-hospital mortality were assessed. Results A total of 7%(99 of 1392) of patients developed AKI during hospitalization, 40%(40 of 99) of which occurred within 1 week of admission. Factors associated with a higher risk of AKI include severe disease (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.37 to 3.67), higher baseline serum creatinine (OR, 2.19; 95% CI, 1.17 to 4.11), lymphopenia (OR, 1.99; 95% CI, 1.12 to 3.53), and elevated D-dimer level (OR, 2.68; 95% CI, 1.07 to 6.70). The in-hospital mortality in patients with AKI stage 1, stage 2, and stage 3 was 62%, 77%, and 80%, respectively. AKI was associated with in-hospital mortality even after adjustment for confounders (OR, 5.12; 95% CI, 2.70 to 9.72). Conclusions AKI is uncommon but carries high in-hospital mortality in patients with COVID-19.
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