ACUTE KIDNEY INJURY IN HOSPITALIZED COVID-19 PATIENTS: A RETROSPECTIVE OBSERVATIONAL STUDY

Authors

  • Mohammad Asim Department of Medicine, Northwest General Hospital and Research Center, Peshawar.
  • Sartaj Alam Department of Nephrology, Peshawar Medical College, Peshawar.
  • Najmush Shakireen Combined Military Hospital, Peshawar
  • Rabia Saeed Department of Medicine, Northwest General Hospital and Research Center, Peshawar.
  • Arslan Rahat Ullah Department of Medicine, Northwest General Hospital and Research Center, Peshawar.
  • Zain ul Abideen Department of Physiology, KMU-IMS, Kohat.

DOI:

https://doi.org/10.55519/JAMC-03-S1-9734

Keywords:

Acute kidney injury, COVID-19, Inflammatory markers, inpatient mortality

Abstract

Background: Published studies have reported that acute kidney injury (AKI) and other kidney related manifestations are associated with COVID-19 and linked with poor outcome. This study aimed to determine the incidence, risk factors and outcomes of AKI in hospitalized COVID-19 patients. Methods: This retrospective study of 154 patients involved retrieving data from hospital records confirm COVID-19 infection admitted to the Northwest General Hospital & Research Center, Peshawar from 1st April to 31st July 2020. AKI was defined using Kidney disease. Improving Global Outcomes (KDIGO)” guidelines. Results: Incidence of AKI was 37.01%. Age, gender, intensive care (ICU) requirement, number of co-morbid, diabetes mellitus, coronary artery disease, chronic kidney disease, chronic obstructive airway disease (COAD), arrhythmias among comorbid and fever and shortness of breath among symptoms were found to be significantly differed between AKI and non-AKI patients. Numerous differences of laboratory results such as serum sodium, potassium, total leukocyte count, absolute lymphocyte count and platelets between both groups were observed (p<0.05). Inflammatory markers including lactate dehydrogenase (LDH), ferritin, d-dimer and C-reactive protein (CRP) were significantly raised in AKI group. Overall mortality was observed to be 38 (24.7%). Moreover, age, ICU requirement; COAD, creatinine, serum sodium, inflammatory markers (LDH, ferritin, d-dimers and CRP), total leukocyte count, absolute lymphocyte count, platelets and support requirement were significantly differed between survivors and non-survivors.  Mortality was significantly higher among AKI group, i.e., 52.6% compared to 8.2% in non-AKI group (p<0.001). Conclusion: AKI is common among hospitalized COVID-19 patients and is associated with mortality. In all, AKI patients less than half of the patients survived. 

References

Chan L, Chaudhary K, Saha A, Chauhan K, Vaid A, Zhao S, et al. AKI in hospitalized patients with COVID-19. J Am Soc Nephrol 2021;32(1):151–60.

Rudnick MR, Hilburg R. Acute Kidney Injury in COVID-19: Another Challenge for Nephrology. Am J Nephrol 2020;51(10):761–3.

Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020;97(5):829–38.

Hirsch JS, Ng JH, Ross DW, Sharma P, Shah HH, Barnett RL, et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int 2020;98(1):209–18.

Nadim MK, Forni LG, Mehta RL, Connor MJ, Liu KD, Ostermann M, et al. COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup. Nat Rev Nephrol 2020;16(12):747–64.

Zahid U, Ramachandran P, Spitalewitz S, Alasadi L, Chakraborti A, Azhar M, et al. Acute kidney injury in COVID-19 patients: An inner city hospital experience and policy implications. Am J Nephrol 2020;51(10):786–96.

Kolhe NV, Fluck RJ, Selby NM, Taal MW. Acute kidney injury associated with COVID-19: A retrospective cohort study. PLoS Med 2020;17(10):e1003406.

Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020;323(20):2052–9.

Ul-Haq Z, Shahzad M, Khattak MI, Fazid S, Ullah N, Shireen A, et al. Clinical Characteristics, Mortality and Associated risk factors in COVID-19 patients reported in ten major hospitals of Khyber Pakhtunkhwa, Pakistan. J Ayub Med Coll Abbottabad 2020;32(4 Suppl 1):633–9.

Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020;368:m1091.

Mohamed MM, Lukitsch I, Torres-Ortiz AE, Walker JB, Varghese V, Hernandez-Arroyo CF, et al. Acute kidney injury associated with coronavirus disease 2019 in urban New Orleans. Kidney360 2020;1(7):614–22.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323(11):1061–9.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395(10229):1054–62.

Su H, Yang M, Wan C, Yi LX, Tang F, Zhu HY, et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int 2020;98(1):219–27.

Arshad AR, Khan I, Shahzad K, Arshad M, Haider SJ, Aslam MJ. Association of Inflammatory Markers with Mortality in COVID-19 Infection. J Coll Physicians Surg Pak 2020;30(10):158–63.

Gong Y, Hou J. Claudin-14 Underlies Ca++-Sensing Receptor–Mediated Ca++ Metabolism via NFAT-microRNA–Based Mechanisms. J Am Soc Nephrol 2014;25(4):745–60.

Published

2022-06-24

Issue

Vol. 34 No. 3 (SUPPL 1) (2022): JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD

Section

ORIGINAL ARTICLE

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