Acute kidney injury and mortality risk in older adults with COVID-19

Abstract

Background Research regarding COVID-19 and acute kidney injury (AKI) in older adults is scarce. We evaluated risk factors and outcomes of AKI in hospitalized older adults with and without COVID-19. Methods Observational study of patients admitted to two geriatric clinics in Stockholm from March 1st to June 15th, 2020. The difference in incidence, risk factors and adverse outcomes for AKI between patients with or without COVID-19 were examined. Odds ratios (OR) for the risk of AKI and in-hospital death were obtained from logistic regression. Results Three hundred-sixteen older patients were hospitalized for COVID-19 and 876 patients for non-COVID-19 diagnoses. AKI occurred in 92 (29%) patients with COVID-19 vs. 159 (18%) without COVID-19. The odds for developing AKI were higher in patients with COVID-19 (adjusted OR, 1.70; 95% confidence interval [CI] 1.04–2.76), low baseline kidney function as depicted by estimated glomerular filtration rate (eGFR) [4.19 (2.48–7.05), for eGFR 30 to < 60 mL/min, and 20.3 (9.95–41.3) for eGFR < 30 mL/min], and higher C reactive protein (CRP) (OR 1.81 (1.11–2.95) in patients with initial CRP > 10 mg/L). Compared to patients without COVID-19 and without AKI, the risk of in-hospital death was highest in patients with COVID-19 and AKI [OR 80.3, 95% CI (27.3–235.6)], followed by COVID-19 without AKI [16.3 (6.28–42.4)], and by patients without COVID-19 and with AKI [10.2 (3.66–28.2)]. Conclusions Geriatric patients hospitalized with COVID-19 had a higher incidence of AKI compared to patients hospitalized for other diagnoses. COVID-19 and reduced baseline kidney function were risk factors for developing AKI. AKI and COVID-19 were associated with in-hospital death.

Catechins: Therapeutic Perspectives in COVID-19-Associated Acute Kidney Injury

“…COVID-19 patients have shown an unpredictable and variable clinical outcome that ranges from asymptomatic presentation to multiple organ failure and death [ 13 , 14 , 15 ]. Although pulmonary complications have been the main clinical presentation of COVID-19, there is increasing evidence that acute kidney injury (AKI) is strongly associated with the in-hospital high mortality of COVID-19 patients, especially those with underlying comorbidities and/or who require renal replacement therapy (RRT) [ 16 , 17 , 18 ]. AKI can lead to serious complications, such as hydro-electrolytic disturbance, alterations in blood pressure control, impairment of acid–base homeostasis, rise of serum concentration of toxic metabolites and increased risk of drug overdose [ 19 , 20 ].…”

Gender and Ethnic Disparities of Acute Kidney Injury in COVID-19 Infected Patients: A Literature Review

“…We identified the data by searching PubMed and references from relevant articles using the search terms “Coronavirus Disease 2019”, “COVID-19”, “SARS-CoV-2”, “kidney disease”, “acute kidney injury”, “AKI”, “risk factors”, “gender”, “clinical outcomes”, and “Clinical Characteristics”. We found that the SARS-CoV-2 infection rate in males is higher than that in females, and the incidence of AKI in males is also higher than that in females in most studies ( Figures 1 , 2 ) ( Cheng et al., 2020b ; Fisher et al., 2020 ; Hirsch et al., 2020 ; Kolhe et al., 2020 ; Pei et al., 2020 ; Sang et al., 2020 ; Zahid et al., 2020 ; Basalely et al., 2021 ; Chan et al., 2021 ; Cheng et al., 2021 ; Costa et al., 2021 ; Dai et al., 2021 ; Diebold et al., 2021 ; Gasparini et al., 2021 ; Martinez-Rueda et al., 2021 ; Mousavi Movahed et al., 2021 ; Ng et al., 2021 ; Ozturk et al., 2021 ; Russo et al., 2021 ; Xu H. et al., 2021 ; Xu J. et al., 2021 ; Yildirim et al., 2021 ; Zamoner et al., 2021 ). In these studies, all of the patients with COVID-19 had new-onset AKI during hospitalization.…”

“…In addition to the higher proportion of males in AKI patients, the incidence of AKI in male patients with COVID-19 is also higher than that in female patients ( Figure 2 ) ( Cheng et al., 2020b ; Fisher et al., 2020 ; Hirsch et al., 2020 ; Kolhe et al., 2020 ; Pei et al., 2020 ; Sang et al., 2020 ; Zahid et al., 2020 ; Basalely et al., 2021 ; Chan et al., 2021 ; Cheng et al., 2021 ; Costa et al., 2021 ; Dai et al., 2021 ; Diebold et al., 2021 ; Gasparini et al., 2021 ; Martinez-Rueda et al., 2021 ; Mousavi Movahed et al., 2021 ; Ng et al., 2021 ; Ozturk et al., 2021 ; Russo et al., 2021 ; Xu H. et al., 2021 ; Xu J. et al., 2021 ; Yildirim et al., 2021 ; Zamoner et al., 2021 ). According to the previously mentioned mechanism of SARS-CoV-2 directly invading kidney host cells to cause AKI, ACE2 and TMPRSS2 are expressed in proximal convoluted tubule cells and podocytes ( He et al., 2020 ).…”

COVID-19 Infection in Kidney Transplant Patients: An Italian One Year Single Centre Experience

“…AKI could be secondary to several factors, including a direct viral damage and an immune-mediated damage: the so-called cytokine storm [ 12 ]. The incidence of AKI in the general population has been reported in 5.1% up to 29 of cases according to age [ 13 , 14 ]. In our series, AKI cumulative incidence was 13.4% (11 patients): 22.2% in the first outbreak (6 patients) and 12% in the second (5 patients).…”