Acute Kidney Injury in Patients with the Coronavirus Disease 2019: A Multicenter Study

Abstract

Introduction: Severe acute respiratory viral infections are frequency accompanied by multiple organ dysfunction, including acute kidney injury (AKI). In December 2019, the coronavirus disease 2019 (COVID-19) outbreak began in Wuhan, Hubei Province, China, and rapidly spread worldwide. While diffuse alveolar damage and acute respiratory failure are the main features of COVID-19, other organs may be involved, and the incidence of AKI is not well described. We assessed the incidence and clinical characteristics of AKI in patients with laboratory-confirmed COVID-19 and its effects on clinical outcomes. Methods: We conducted a multicenter, retrospective, observational study of patients with COVID-19 admitted to two general hospitals in Wuhan from 5 January 2020 to 21 March 2020. Demographic data and information on organ dysfunction were collected daily. AKI was defined according to the KDIGO clinical practice guidelines. Early and late AKI were defined as AKI occurring within 72 h after admission or after 72 h, respectively. Results: Of the 116 patients, AKI developed in 21 (18.1%) patients. Among them, early and late AKI were found in 13 (11.2%) and 8 (6.9%) patients, respectively. Compared with patients without AKI, patients with AKI had more severe organ dysfunction, as indicated by a higher level of disease severity status, higher sequential organ failure assessment (SOFA) score on admission, an increased prevalence of shock, and a higher level of respiratory support. Patients with AKI had a higher SOFA score on admission (4.5 ± 2.1 vs. 2.8

Stratification of Acute Kidney Injury in COVID-19

“… 21 Available studies 10 , 11 , 22 – 24 have reported various risk factors for the development of AKI during the course of COVID-19 as described in Figure 1 . Taken together, in contrast to the results of Wang et al, 2 these findings underscore that AKI is frequently encountered 10 highly morbid and fatal complication 10 , 14 , 22 , 23 during COVID-19 and warrant the dire need of nephrology consultation. However, these studies are accompanied by potential limitations including the less number of patients, unavailability of baseline SCr, disparity in AKI diagnostic criteria, and lack of follow-up to ascertain the renal recovery.…”

COVID-19 and the Kidney: A Worrisome Scenario of Acute and Chronic Consequences

“…Initial descriptions from countries first affected in Asia reported a lower incidence of AKI when compared to data obtained from Europe and North America [ 12 , 14 , 19 , 20 ]. In two single-center reports from China, AKI among hospitalized patients is described to be between 4.5% and 7%, with higher incidences within cohorts including critically ill patients [ 21 , 22 , 23 , 24 , 25 , 26 ]. This is in contrast with data available from the United States.…”

A Comparative COVID 19 Characterizations and Clinical Course Analysis between ICU and Non ICU Settings

“…This cohort had a median LOS of 8.5 days, which increased to 11 days for ICU patients. The overall LOS was comparable to two cohorts in China with median LOS of 11 and 12 days respectively [8, 28] One patient in ICU had a 69 days hospital stay which significantly widened the median range. With updated treatment plans the median LOS will continue to reduce given that protocols are established.…”