Acute kidney injury in hospitalized patients with COVID-19

Gameiro, Joana; Fonseca, José Agapito; Oliveira, João; Marques, Filipe; Bernardo, João; Costa, Cláudia; Carreiro, Carolina; Bráz, Sandra; Alvoeiro, Lourdes; Lopes, José António

doi:10.21203/rs.3.rs-39131/v1

Cited by 6 publications

(7 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the design of the study, two sets of reports were identified. The first set was constituted by studies listed in Table 1 and Table 2 and Supplementary Table S1 ( n = 22; n = 8792 patients) which evaluated the frequency of AKI based on the severity of COVID-19 [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. The frequency of chronic obstructive pulmonary disease (COPD) ranged between 1.1 and 13%, and the chronic liver disease (CLD) rate between 0.9% and 11.8%.…”

Section: Resultsmentioning

confidence: 99%

“…The second set included reports shown in Table 3 and Table 4 and Supplementary Table S2 ( n = 20, n = 16,774 patients) which assessed the impact of AKI development upon the outcomes (death rate) of COVID-19 patients [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. Some ( n = 3) studies gave information on both relationships [ 16 , 24 , 28 ]. The frequency of COPD varied between 1.9 and 12%, and the rate of CLD between 0.52% and 6.3%.…”

Section: Resultsmentioning

confidence: 99%

“… Chan L. et al [ 28 ]: aRR adjusted for age, gender, comorbidities including hypertension, congestive heart failure, diabetes mellitus, liver disease, peripheral vascular disease, chronic kidney disease, laboratory values including white blood cell count, lymphocyte percentage, hemoglobin, platelets, sodium, potassium, chloride, bicarbonate, urea, creatinine, aspartate aminostransferase, alanine aminotransferase, alkaline phosphatase, albumin, and vitals (including systolic blood pressure, diastolic BP, heart rate, respiratory rate, oxygen saturation). Cheng Y. et al [ 37 ]: aRR adjusted for age, gender, disease severity, any comorbidity (CKD, chronic obstructive pulmonary disease (COPD), hypertension, diabetes, and tumor), and lymphocyte count.…”

Section: Figurementioning

confidence: 99%

See 2 more Smart Citations

COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis

et al. 2020

View full text Add to dashboard Cite

Background: coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome—coronavirus-2 (SARS-CoV-2)—is an ongoing pandemic with high morbidity and mortality rates. Preliminary evidence suggests that acute kidney injury (AKI) is uncommon in patients with COVID-19 and associated with poor outcomes. Study aims and design: we performed a systematic review of the literature with a meta-analysis of clinical studies to evaluate the frequency of AKI and dialysis requirement in patients who underwent hospitalization due to COVID-19. The incidence of AKI according to the death risk was calculated in these patients. The random-effects model of DerSimonian and Laird was adopted, with heterogeneity and stratified analyses. Results: thirty-nine clinical studies (n = 25,566 unique patients) were retrieved. The pooled incidence of AKI was 0.154 (95% CI, 0.107; 0.201; p < 0.0001) across the studies. Significant heterogeneity was found (p = 0.0001). The overall frequency of COVID-19-positive patients who underwent renal replacement therapy (RRT) was 0.043 (95% CI, 0.031; 0.055; p < 0.0001); no publication bias was found (Egger’s test, p = 0.11). The pooled estimate of AKI incidence in patients with severe COVID-19 was 0.53 (95% CI, 0.427; 0.633) and heterogeneity occurred (Q = 621.08, I2 = 97.26, p = 0.0001). According to our meta-regression, age (p < 0.007) and arterial hypertension (p < 0.001) were associated with AKI occurrence in hospitalized COVID-19 positive patients. The odds ratio (OR) for the incidence of AKI in deceased COVID-19 positive patients was greater than among survivors, 15.4 (95% CI, 20.99; 11.4; p < 0.001). Conclusions: AKI is a common complication in hospitalized COVID-19 positive patients. Additional studies are under way to assess the risk of AKI in COVID-19 patients and to deepen the mechanisms of kidney injury.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

See 1 more Smart Citation

COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Among critically ill patients, 30% developed AKI during admission and 9% had pre-hospital AKI. In another study analysing AKI incidence in COVID patients Chung M et al [27] describe that AKI occurred in 1,406 (46%) patients overall, when referring to critically ill patients the incidence rises to 68% (admission plus new cases).…”

Section: Plos Onementioning

confidence: 99%

“Acute kidney injury in critically ill patients with COVID–19: The AKICOV multicenter study in Catalonia”

et al. 2023

View full text Add to dashboard Cite

This study describes the incidence, evolution and prognosis of acute kidney injury (AKI) in critical COVID-19 during the first pandemic wave. We performed a prospective, observational, multicenter study of confirmed COVID-19 patients admitted to 19 intensive care units (ICUs) in Catalonia (Spain). Data regarding demographics, comorbidities, drug and medical treatment, physiological and laboratory results, AKI development, need for renal replacement therapy (RRT) and clinical outcomes were collected. Descriptive statistics and logistic regression analysis for AKI development and mortality were used. A total of 1,642 patients were enrolled (mean age 63 (15.95) years, 67.5% male). Mechanical ventilation (MV) was required for 80.8% and 64.4% of these patients, who were in prone position, while 67.7% received vasopressors. AKI at ICU admission was 28.4% and increased to 40.1% during ICU stay. A total of 172 (10.9%) patients required RRT, which represents 27.8% of the patients who developed AKI. AKI was more frequent in severe acute respiratory distress syndrome (ARDS) ARDS patients (68% vs 53.6%, p<0.001) and in MV patients (91.9% vs 77.7%, p<0.001), who required the prone position more frequently (74.8 vs 61%, p<0.001) and developed more infections. ICU and hospital mortality were increased in AKI patients (48.2% vs 17.7% and 51.1% vs 19%, p <0.001) respectively). AKI was an independent factor associated with mortality (IC 1.587–3.190). Mortality was higher in AKI patients who required RRT (55.8% vs 48.2%, p <0.04). Conclusions There is a high incidence of AKI in critically ill patients with COVID-19 disease and it is associated with higher mortality, increased organ failure, nosocomial infections and prolonged ICU stay.

show abstract

“…Researchers in China found that 5%-29% of patients diagnosed with COVID-19 had AKI within 7-14 days of hospital admission, whereas researchers in the United States found far higher rates of 37%-57% in COVID-19 patients. 3,4,23,[38][39][40] An estimated 29% of all ICU patients suffer from AKI, which rises to 78% among intubated patients. 41 According to other research, up to 20% of ICU patients need KRT.…”

Section: Epidemiology Of Aki In Covid-19mentioning

confidence: 99%

Targeting TLR-4 Signaling to Treat COVID-19-induced Acute Kidney Injury

Almazmomi

Alsieni

2022

Journal of Pharmacology and Pharmacotherapeutics

View full text Add to dashboard Cite

The newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has turned into a potentially fatal pandemic illness. Numerous acute kidney injury (AKI) cases have been reported, although diffuse alveolar destruction and acute respiratory failure are the major symptoms of SARS-CoV-2 infection. The AKI, often known as a sudden loss of kidney function, carries a greater risk of mortality and morbidity. AKI was the second most frequent cause of death after acute respiratory distress syndrome (ARDS) in critically ill patients with coronavirus disease 2019 (COVID-19). While most patients with COVID-19 have moderate symptoms, some have severe symptoms, such as septic shock and ARDS. Also, it has been proven that some patients have severe symptoms, such as the failure of several organs. The kidneys are often affected either directly or indirectly. The major signs of kidney involvement are proteinuria and AKI. It is hypothesized that multiple mechanisms contribute to kidney injury in COVID-19. Direct infection of podocytes and proximal tubular cells in the kidneys may lead to acute tubular necrosis and collapsing glomerulopathy. SARS-CoV2 may also trigger a cascade of immunological responses that lead to AKI, including cytokine storm (CS), macrophage activation syndrome, and Toll-like receptor type-4 activation (TLR-4). Other proposed processes of AKI include interactions between organs, endothelial failure, hypercoagulability, rhabdomyolysis, and sepsis. Furthermore, ischemic damage to the kidney might result from the decreased oxygen supply. This article focuses on kidney injury’s epidemiology, etiology, and pathophysiological processes. Specifically, it focuses on the CS and the role of TLR-4 in this process. To effectively manage and treat acute kidney damage and AKI in COVID-19, it is crucial to understand the underlying molecular pathways and pathophysiology.

show abstract

Acute kidney injury in hospitalized patients with COVID-19

Cited by 6 publications

References 33 publications

COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis

COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis

“Acute kidney injury in critically ill patients with COVID–19: The AKICOV multicenter study in Catalonia”

Targeting TLR-4 Signaling to Treat COVID-19-induced Acute Kidney Injury

Contact Info

Product

Resources

About