Treatment Outcome of Acute Kidney Injury in Patients with COVID-19 Infection

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Narongchai Sangsa

Abstract

In the condition that acute kidney injury (AKI) is caused by COVID-19 infection, if patients are treated promptly, there is a chance that the kidney will recover back to normal. This study aimed to determine the treatment outcomes of patients with AKI from COVID-19 infection and risk factors for mortality. The study design was a retrospective cohort study. All data were collected from medical records of patients with COVID-19 infected and diagnosed with AKI from January 1, 2020 to May 31, 2022. The statistic used for data analysis was multiple logistic regressions. The results revealed that 96 patients were COVID-19 infection and diagnosed with AKI and all of them received antiviral therapy treatment, 60 recovered, 36 died, 42 developed severe pneumonia requiring ventilators, 11 required renal replacement therapy, and 5 progressed to CKD. Risk factors of mortality were female (AOR = 2.02; 95%CI: 1.74-5.45), aged 61-70 years (AOR = 3.78; 95%CI: 1.83-7.20), aged >70 years (AOR = 2.17; 95%CI: 1.66-7.10), AKI stage 2 (AOR = 2.52; 95%CI: 1.12-6.32), AKI stage 3 (AOR = 2.96; 95%CI: 1.37-9.62), ICU admission (AOR = 2.98; 95%CI: 1.79-11.25), mechanical ventilators used (AOR = 3.71; 95%CI: 1.33-10.34), and septic shock (AOR = 2.24; 95%CI: 1.67-7.44). In conclusion, 60 patients were cured and 5 patients progressed to CKD. The risk factors for mortality among COVID-19 patients with AKI development were AKI, gender, age, septic shock, severely ill patients admitted to intensive care units, and ventilator use.

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1.
Sangsa N. Treatment Outcome of Acute Kidney Injury in Patients with COVID-19 Infection. Health Sci J Thai [Internet]. 2023 Feb. 28 [cited 2024 Mar. 29];5(2):31-40. Available from: https://he02.tci-thaijo.org/index.php/HSJT/article/view/259301
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Original articles

References

WHO Coronavirus (COVID-19) Dashboard [Internet]. [cited 2022 Aug 29]. Available from: https://covid19.who.int

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.

Guan W jie, Ni Z yi, Hu Y, Liang W hua, Ou C quan, He J xing, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; NEJMoa 2002032.

Intensive Care National Audit & Research Centre: ICNARC report on COVID-19 in critical care, 2020. [Internet]. [cited 2022 Sep 5] Available at: https://www.icnarc.org/DataServices/Attachments/Download/c31dd38d-d77b-ea11-9124-00505601089b.

Abelson R, Fink S, Kulish N, Thomas K: An overlooked, possibly fatal coronavirus crisis: A dire need for kidney dialysis. New York Times, 2020. [Internet]. [cited 2022 Aug 29] Available at: https://www.nytimes.com/2020/04/18/health/kidney-dialysis-coronavirus.html.

Goldfarb DS, Benstein JA, Zhdanova O, Hammer E, Block CA, Caplin NJ, et al. Impending Shortages of Kidney Replacement Therapy for COVID-19 Patients. Clin J Am Soc Nephrol CJASN 2020; 15(6):880–2.

Farouk SS, Fiaccadori E, Cravedi P, Campbell KN. COVID-19 and the kidney: what we think we know so far and what we don’t. J Nephrol 2020; 33(6): 1213–8.

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 ;1–11.

Mohamed MMB, 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.

Acute Kidney Injury (AKI) – KDIGO [Internet]. [cited 2022 Sep 5]. Available from: https://kdigo.org/guidelines/acute-kidney-injury/

Susantitaphong P, Cruz DN, Cerda J, Abulfaraj M, Alqahtani F, Koulouridis I, et al. World incidence of AKI: a meta-analysis. Clin J Am Soc Nephrol CJASN 2013;8(9):1482–93.

Hoste EAJ, Schurgers M. Epidemiology of acute kidney injury: how big is the problem? Crit Care Med 2008;36(4 Suppl):S146-151.

Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, et al. Acute renal failure in critically ill patients: a multinational, multicenter study JAMA. 2005;294(7):813–8.

Pei G, Zhang Z, Peng J, Liu L, Zhang C, Yu C, et al. Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia. J Am Soc Nephrol JASN 2020;31(6):1157–65.

Heung M, Steffick DE, Zivin K, Gillespie BW, Banerjee T, Hsu CY, et al. Acute Kidney Injury Recovery Pattern and Subsequent Risk of CKD: An Analysis of Veterans Health Administration Data. Am J Kidney Dis Off J Natl Kidney Found 2016;67(5):742–52.

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 Lond Engl 2020; 395(10229): 1054–62.

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.

Zheng X, Yang H, Li X, Li H, Xu L, Yu Q, et al. Prevalence of Kidney Injury and Associations with Critical Illness and Death in Patients with COVID-19. Clin J Am Soc Nephrol CJASN 2020; 15(11): 1549–56.

Biswas M, Rahaman S, Biswas TK, Haque Z, Ibrahim B. Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis. Intervirology 2020;1–12.

Zhang JJY, Lee KS, Ang LW, Leo YS, Young BE. Risk Factors for Severe Disease and Efficacy of Treatment in Patients Infected With COVID-19: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis. Clin Infect Dis Off Publ Infect Dis Soc Am 2020;71(16):2199–206.

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 Lond Engl 2020; 395(10229): 1054–62.

Moutchia J, Pokharel P, Kerri A, McGaw K, Uchai S, Nji M, et al. Clinical laboratory parameters associated with severe or critical novel coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. PLoS ONE 2020;15(10): e0239802.

Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. Aging Male Off J Int Soc Study Aging Male 2020; 23(5): 1416–24.

Rodriguez-Gonzalez CG, Chamorro-de-Vega E, Valerio M, Amor-Garcia MA, Tejerina F, Sancho-Gonzalez M, et al. COVID-19 in hospitalised patients in Spain: a cohort study in Madrid. Int J Antimicrob Agents 2021;57(2):106249.

Ferrando C, Mellado-Artigas R, Gea A, Arruti E, Aldecoa C, Bordell A, et al. Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: A prospective, cohort, multicentre study. Rev Esp Anestesiol Reanim 2020;67(8):425–37.