Incidence and predictors of acute kidney injury among hospitalized patients with COVID-19 infection

Hayder Aledan, Shawqi Azeez, A. Shannan, Ammar Husaini, Muqtader Abdulhussein
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Abstract

Background and objectives: Acute kidney injury (AKI) may occur in the setting of COVID-19 infection and associated with worse outcome. We aimed to estimate the incidence of AKI among hospitalized patients with COVID-19 infection. Methods: We conducted an observational study on 339 hospitalized patients with COVID-19 infection at Basra teaching hospital for two months. We studied the rate of AKI, requirement for renal replacement therapy (RRT) and in-hospital mortality. Results: Among 339 hospitalized patients, AKI was reported in 54 (16%). The peak stages of AKI were stage 1 in 42.6%, stage 2 in 22.2% and stage 3 in 35.2%. AKI was primarily seen in patients with shock on vasopressors in 64.8% and in patients on mechanical ventilation in 25.9%. Increased age, obesity, hypertension, vasopressors and mechanical ventilation were independent risk factors for development of AKI. Among the 54 patients with AKI, 20 patients (37%) required renal replacement therapy (RRT). Sixteen out of 20 patients (80%) of those who required RRT died and only 5 out of 34 patients (15%) of those not required RRT died with a totally mortality in AKI patients of 21 patients (39%). Conclusions: AKI occurs in patients with COVID-19 disease especially in ICU in association with vasopressors use and mechanical ventilation and is associated with poor prognosis.
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COVID-19感染住院患者急性肾损伤的发生率及预测因素
背景和目的:急性肾损伤(AKI)可能发生在COVID-19感染的情况下,并与较差的预后相关。我们的目的是估计COVID-19感染住院患者AKI的发生率。方法:对巴士拉教学医院住院的339例COVID-19感染患者进行为期2个月的观察性研究。我们研究了AKI的发生率、肾替代治疗(RRT)的需求和住院死亡率。结果:在339例住院患者中,54例(16%)报告了AKI。AKI的高峰分期为1期(42.6%)、2期(22.2%)和3期(35.2%)。急性肾损伤主要见于血管加压药物休克患者(64.8%)和机械通气患者(25.9%)。年龄增加、肥胖、高血压、血管加压药物和机械通气是AKI发生的独立危险因素。在54例AKI患者中,20例(37%)患者需要肾替代治疗(RRT)。20例需要RRT的患者中有16例(80%)死亡,34例不需要RRT的患者中只有5例(15%)死亡,AKI患者的总死亡率为21例(39%)。结论:AKI发生在COVID-19患者中,特别是ICU患者,与血管加压药的使用和机械通气有关,且与预后不良相关。
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