Community- and Hospital-Acquired Acute Kidney Injury in COVID-19: Different Phenotypes and Dismal Prognosis

Martínez-Rueda, Armando J.; Álvarez, Rigoberto D.; Méndez-Pérez, R Angélica; Fernández‐Camargo, Dheni A.; Gaytan-Arocha, Jorge E.; Berman-Parks, Nathan; Flores-Camargo, Areli; Comunidad-Bonilla, Roque A; Mejía-Vilet, Juan M.; Arvizu-Hernández, Mauricio; Ramirez‐Sandoval, Juan C.; Correa‐Rotter, Ricardo; Vega-Vega, Olynka

doi:10.1159/000513948

Cited by 28 publications

(43 citation statements)

References 45 publications

(63 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Almost two thirds of our patients presented with AKI at the moment of admission, most of them being known with a history of CKD. Numerous studies report that AKI at admission is frequent in COVID-19 (34)(35)(36), but, regarding prevalence of previous CKD, some authors found it higher in AKI at admission (34,37) similar to our study, whereas others in hospital-developed AKI (38). This difference was probably due to the modality of admission in the hospital, availability and extension of ICU departments in different hospitals, type of treatment available and recommended by evolving guidelines in the last year of the pandemic.…”

Section: Impact Of Covid-19-specific Treatment and Severity Of Akisupporting

confidence: 77%

See 1 more Smart Citation

Acute kidney injury in moderate and severe COVID‑19 patients: Report of two university hospitals

et al. 2021

View full text Add to dashboard Cite

Section: Impact Of Covid-19-specific Treatment and Severity Of Akisupporting

confidence: 77%

“…We found no differences between AKI at admission and hospital-acquired AKI regarding age or comorbid burden. Most authors report age and multiple comorbidities as predictive factors for AKI at admission (34,37) and few found advanced age to be associated with hospital-acquired AKI (38).…”

Section: Impact Of Covid-19-specific Treatment and Severity Of Akimentioning

confidence: 99%

Acute kidney injury in moderate and severe COVID‑19 patients: Report of two university hospitals

et al. 2021

View full text Add to dashboard Cite

“…After reviewing the full texts of 938 articles, 71 COVID-19 studies were included in the meta-analysis ( Figure 1A ). 1 - 3 , 13 , 27 …”

Section: Resultsmentioning

confidence: 99%

Acute Kidney Injury and Renal Replacement Therapy in COVID-19 Versus Other Respiratory Viruses: A Systematic Review and Meta-Analysis

Cau

Cheng

Lee

et al. 2021

Can J Kidney Health Dis

View full text Add to dashboard Cite

Background: Acute kidney injury (AKI) is a potentially fatal complication of Coronavirus Disease-2019 (COVID-19). Binding of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, to its viral receptor, angiotensin converting enzyme 2 (ACE2), results in viral entry and may cause AKI. Objectives: We performed a systematic review and meta-analysis of the frequencies of AKI and renal replacement therapy (RRT) in critically ill COVID-19 patients and compared those frequencies with patients who were infected by respiratory viruses that bind or downregulate ACE2 (ACE2-associated viruses) and viruses that do not bind nor downregulate ACE2 (non-ACE2-associated viruses). Design: Systematic review and meta-analysis. Setting: Observational studies on COVID-19 and other respiratory viral infections reporting AKI and RRT were included. The exclusion criteria were non-English articles, non-peer-reviewed articles, review articles, studies that included patients under the age of 18, studies including fewer than 10 patients, and studies not reporting AKI and RRT rates. Patients: Adult COVID-19, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and influenza patients. Measurements: We extracted the following data from the included studies: author, year, study location, age, sex, race, diabetes mellitus, hypertension, chronic kidney disease, shock, vasopressor use, mortality, intensive care unit (ICU) admission, ICU mortality, AKI, and RRT. Methods: We systematically searched PubMed and EMBASE for articles reporting AKI or RRT. AKI was defined by authors of included studies. Critical illness was defined by ICU admission. We performed a random effects meta-analysis to calculate pooled estimates for the AKI and RRT rate within each virus group using a random intercept logistic regression model. Results: Of 23 655 hospitalized, critically ill COVID-19 patients, AKI frequencies were not significantly different between COVID-19 patients (51%, 95% confidence interval [CI]: 44%-57%) and critically ill patients infected with ACE2-associated (56%, 95% CI: 37%-74%, P = .610) or non-ACE2-associated viruses (63%, 95% CI: 43%-79%, P = .255). Pooled RRT rates were also not significantly different between critically ill, hospitalized patients with COVID-19 (20%, 95% CI: 16%-24%) and ACE2-associated viruses (18%, 95% CI: 8%-33%, P = .747). RRT rates for both COVID-19 and ACE2-associated viruses were significantly different ( P < .001 for both) from non-ACE2-associated viruses (49%, 95% CI: 44%-54%). After adjusting for shock or vasopressor use, AKI and RRT rates were not significantly different between groups. Limitations: Limitations of this study include the heterogeneity of definitions of AKI that were used across different virus studies. We could not match severity of infection or do propensity matching across studies. Most of the included studies were conducted in retrospective fashion. Last, we did not include non-English publications. Conclusions: Our findings suggest that viral ACE2 association does not significantly alter the rates of AKI and RRT among critically ill patients admitted to the ICU. However, the rate of RRT is lower in patients with COVID-19 or ACE2-associated viruses when compared with patients infected with non-ACE2-binding viruses, which might partly be due to the lower frequencies of shock and use of vasopressors in these two virus groups. Prospective studies are necessary to demonstrate whether modulation of the ACE2 axis with Renin-Angiotensin System inhibitors impacts the rates of AKI and whether they are beneficial or harmful in COVID-19 patients.

show abstract

“…[2][3][4] The rate of AKI in patients with COVID-19 is extremely variable across countries and may differently affect patients with similar disease severity. [5] In a large cohort of vulnerable patients in the USA, the incidence of AKI approached 60%. [6] In Europe, few studies have reported information on AKI in the general population.…”

Section: Introductionmentioning

confidence: 99%

Similar Rates of AKI during the First Two Waves of COVID-19 in Northern Italy: a single-center study

Giovanella

Fontana

Milić

et al. 2021

Preprint

View full text Add to dashboard Cite

Introduction: Two waves of COVID-19 cases have overwhelmed most European countries during 2020. It is unclear if the incidence of acute kidney injury (AKI) has changed during the COVID-19 outbreaks. This study aims to evaluate the differences in incidence, risk factors and outcome of AKI in patients with SARS-CoV-2 infection during the first and second wave of COVID-19. Method: We reviewed the health medical records of 792 consecutive patients with COVID-19 hospitalized at the University Hospital of Modena, Italy, from February 25 to December 14, 2020. Results: AKI was diagnosed in 122 (15.4%) patients. Incidence of AKI remained steady rate during wave-1 (15.9%) and wave-2 (14.7%) (P=0.89). AKI patients were older (P=<0.001) and had a more severe respiratory impairment (PO2/FO2) (P=≤0.001) than their non-AKI counterparts. AKI led to a longer hospital stay (P=0.001), complicated with a higher rate of ICU admission. COVID-19-related AKI was associate with 59.7% of deaths during wave-1 and 70.6% during wave-2. At the end of the period of observation, 24% (wave-1) and 46.7% (wave-2) of survivors were discharged with a not fully recovered kidney function. Risk factors for AKI in patients with COVID-19 were diuretics (HR=5.3; 95%CI, 1.2-23.3; P=0.025) and cardiovascular disease (HR, 2.23; 95%CI, 1.05-5.1; P=0.036). Conclusion: The incidence of AKI (about 15%) remained unchanged during 2020, regardless of the trend of COVID-19. AKI occurred in patients with severe COVID-19 symptoms and was associated with a higher incidence of deaths than non-AKI patients. The risk factors of COVID-19-related AKI were diuretic therapy and cardiovascular disease.

show abstract

Community- and Hospital-Acquired Acute Kidney Injury in COVID-19: Different Phenotypes and Dismal Prognosis

Cited by 28 publications

References 45 publications

Acute kidney injury in moderate and severe COVID‑19 patients: Report of two university hospitals

Acute kidney injury in moderate and severe COVID‑19 patients: Report of two university hospitals

Acute Kidney Injury and Renal Replacement Therapy in COVID-19 Versus Other Respiratory Viruses: A Systematic Review and Meta-Analysis

Similar Rates of AKI during the First Two Waves of COVID-19 in Northern Italy: a single-center study

Contact Info

Product

Resources

About