Incidence and predictors of acute kidney injury among hospitalized patients with COVID-19 infection

Abstract

Abstract Background and objectives: Acute kidney injury (AKI) may occur in the setting of COVID-19 infection and associated with worse outcome. We aimed to estimate the incidence of AKI among hospitalized patients with COVID-19 infection. Methods: We conducted an observational cohort study on 339 hospitalized patients with COVID-19 infection at Basra teaching hospital for two months. We studied the rate of AKI, requirement for renal replacement therapy (RRT) and in-hospital mortality. Results: Among 339 hospitalized patients, AKI was reported in 54 (16%). The peak stages of AKI were stage 1 in 42.6%, stage 2 in 22.2% and stage 3 in 35.2%. AKI was primarily seen in patients with shock on vasopressors in 64.8% and in patients on mechanical ventilation in 25.9%. Increased age, obesity, hypertension, vasopressors and mechanical ventilation were independent risk factors for development of AKI. Among the 54 patients with AKI, 20 patients (37%) required renal replacement therapy (RRT). Sixteen out of 20 patients (80%) of those who required RRT died and only 5 out of 34 patients (15%) of those not required RRT died with a totally mortality in AKI patients of 21 patients (39%). Conclusions: AKI occurs in patients with COVID-19 disease especially in ICU in association with vasopressors use and mechanical ventilation and is associated with poor prognosis.

Keywords

• covid-19
• acute kidney injury
• intensive care unit
• mechanical ventilation
• vasopressors