Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Lucie Bandelac, Kaanan D. Shah, Pravish Purmessur, Haider Ghazanfar, R. Nasr
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引用次数: 4

Abstract

Purpose To determine the incidence, mortality, stage, and recovery of acute kidney injury (AKI) in COVID-19 patients and further analyze the effect of patient demographics and comorbidities on AKI incidence. Study Design Our study looked at 1545 charts of patients over 18 years old who presented to BronxCare Hospital in NY with a positive SARS-CoV-2 PCR test. Using the KDIGO criteria, any patient presenting with a creatinine of 1.5 times the baseline or that had an increase in creatinine of 0.3mg/dL in 48 hours was diagnosed with AKI. Pregnant patients, patients with end-stage renal disease (ESRD), and patients with a history of renal transplant were excluded. Results The incidence of AKI in COVID-19 patients was 39% (608), and the mortality rate was 58.2% (354). Of the 254 survivors, 74.8% recovered. Moreover, 42.6% (259) of patients with AKI were admitted to the ICU. Twenty-six of our patients received hemodialysis during admission. There was a statistically significant association between AKI and age, race, hypertension (HTN), diabetes mellitus (DM), hepatitis C (HCV), congestive heart failure (CHF), CKD, patient outcome, and days spent in the hospital. Of the 608 patients with AKI, 294 (48.4%), 185 (30.4%) and 129 (21.2%) had AKI stage 1, 2 and 3, respectively. Conclusion Early resource planning is necessary when admitting COVID-19 patients. Nephrology should be consulted early, and measures should be in place to optimize outpatient follow-up in the nephrology clinic. Lastly, the use of nephrotoxic agents should be carefully considered and, if possible, avoided from the time of admission in patients with COVID-19.
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新冠肺炎患者急性肾损伤的发病率、分期和恢复
目的了解2019冠状病毒病(COVID-19)患者急性肾损伤(AKI)的发病率、死亡率、分期及恢复情况,并进一步分析患者人口统计学及合并症对AKI发病率的影响。我们的研究查看了1545例18岁以上的患者的图表,这些患者在纽约布朗克斯医院接受了SARS-CoV-2 PCR检测阳性。使用KDIGO标准,任何出现肌酐为基线的1.5倍或在48小时内肌酐增加0.3mg/dL的患者都被诊断为AKI。排除孕妇、终末期肾病(ESRD)患者和有肾移植史的患者。结果COVID-19患者AKI发生率为39%(608例),死亡率为58.2%(354例)。在254名幸存者中,74.8%康复。此外,42.6%(259)的AKI患者入住ICU。26例患者在入院时接受了血液透析。AKI与年龄、种族、高血压(HTN)、糖尿病(DM)、丙型肝炎(HCV)、充血性心力衰竭(CHF)、慢性肾病(CKD)、患者预后和住院天数有统计学意义的关联。608例AKI患者中,294例(48.4%)、185例(30.4%)和129例(21.2%)分别为AKI一期、二期和三期。结论在收治新冠肺炎患者时,早期做好资源规划是必要的。肾病科应及早会诊,肾病科门诊应采取措施优化门诊随访。最后,应仔细考虑使用肾毒性药物,如果可能的话,从COVID-19患者入院时就应避免使用肾毒性药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.90
自引率
5.00%
发文量
40
审稿时长
16 weeks
期刊介绍: International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.
期刊最新文献
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