Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
Clin Exp Nephrol. 2022 Nov;26(11):1067-1077. doi: 10.1007/s10157-022-02247-4. Epub 2022 Jul 8.
Acute kidney injury (AKI) is associated with morbidity and mortality in COVID-19 patients. The incidence of AKI and its outcomes vary in different parts of the world. We aimed to analyze the AKI incidence, predictors of AKI, mortality, and renal function outcomes on follow-up in hospitalized patients with COVID-19.
The study was designed as a retrospective, observational study of electronically captured data on the hospital information system of laboratory-confirmed COVID-19 patients, with and without AKI, between March 2020 to June 2021. The predictor of AKI and mortality and residual damage in recovered AKI patients were analyzed.
Of the 3395 patients, 3010 COVID-19 patients were eligible. AKI occurred in 951 (31.5%); with stages 1, 2, and 3 in 605 (63.7%), 138 (14.5%), and 208 (21.8%) patients, respectively. AKI severity increased with COVID-19 severity. Of 951 AKI patients, 403 died, and 548 were discharged. AKI group had higher mortality (42.3%) than the non-AKI (6.6%). At discharge, complete recovery was noticed in 370(67.5%), while 178 (32.5%) had residual damage. At three months of follow-up, 108 (69.6%) of 155 patients showed complete recovery. Residual damage was observed in 47 (30.3%). In 14 (9%) patients, serum creatinine remained elevated above the baseline. Thirty-three (21.2%) patients showed proteinuria (n = 24) and microscopic hematuria (n = 9).
AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Residual kidney damage post-COVID-19 in recovered AKI patients may increase the CKD burden.
急性肾损伤（AKI）与 COVID-19 患者的发病率和死亡率相关。AKI 的发病率及其结局在世界不同地区有所不同。我们旨在分析住院 COVID-19 患者 AKI 的发生率、AKI 的预测因素、死亡率和随访时的肾功能结局。
该研究设计为回顾性、观察性研究，对 2020 年 3 月至 2021 年 6 月期间医院信息系统中实验室确诊 COVID-19 患者（有无 AKI）的电子捕获数据进行分析。分析了 AKI 及死亡率的预测因素和恢复 AKI 患者的残留损害。
在 3395 例患者中，有 3010 例 COVID-19 患者符合条件。951 例（31.5%）发生 AKI；其中 605 例（63.7%）为 1 期，138 例（14.5%）为 2 期，208 例（21.8%）为 3 期。AKI 的严重程度随着 COVID-19 严重程度的增加而增加。在 951 例 AKI 患者中，403 例死亡，548 例出院。AKI 组的死亡率（42.3%）高于非 AKI 组（6.6%）。出院时，370 例（67.5%）完全恢复，而 178 例（32.5%）有残留损害。在 3 个月的随访中，155 例患者中有 108 例（69.6%）完全恢复。观察到 47 例（30.3%）有残留损害。在 14 例（9%）患者中，血清肌酐仍高于基线。33 例（21.2%）患者出现蛋白尿（n=24）和镜下血尿（n=9）。
AKI 在住院 COVID-19 患者中很常见，与高死亡率相关。恢复 AKI 患者的 COVID-19 后残留肾损害可能会增加 CKD 负担。
