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Risk Factors, Clinical Characteristics, and Prognosis of Acute Kidney Injury in Hospitalized COVID-19 Patients: A Retrospective Cohort Study

1
Department of Internal Medicine, UPMC Pinnacle, Harrisburg, PA 17104, USA
2
Department of Infectious Diseases, UPMC Pinnacle, Harrisburg, PA 17104, USA
*
Author to whom correspondence should be addressed.
Equivalent contribution.
Received: 16 December 2020 / Revised: 30 December 2020 / Accepted: 4 January 2021 / Published: 7 January 2021
(This article belongs to the Section Nephrology and Urology)
Background: Acute kidney injury (AKI) is a serious complication of COVID-19. Methods: Records of hospitalized adult patients with confirmed SARS-CoV-2 infection from 1 March to 31 May 2020 were retrospectively reviewed. Results: Of 283 patients, AKI occurred in 40.6%. From multivariate analyses, the risk factors of AKI in COVID-19 can be divided into: (1) demographics/co-morbidities (male, increasing age, diabetes, chronic kidney disease); (2) other organ involvements (transaminitis, elevated troponin I, ST segment/T wave change on electrocardiography); (3) elevated biomarkers (ferritin, lactate dehydrogenase); (4) possible bacterial co-infection (leukocytosis, elevated procalcitonin); (5) need for advanced oxygen delivery (non-invasive positive pressure ventilation, mechanical ventilation); and (6) other critical features (ICU admission, need for vasopressors, acute respiratory distress syndrome). Most AKIs were due to pre-renal (70.4%) and intrinsic (34.8%) causes. Renal replacement therapy was more common in intrinsic AKI. Both pre-renal (HR 3.2; 95% CI 1.7–5.9) and intrinsic AKI (HR 7.7; 95% CI 3.6–16.3) were associated with higher mortality. Male, stage 3 AKI, higher baseline and peak serum creatinine and blood urea nitrogen were prevalent in intrinsic AKI. Urine analysis and the fractional excretion of sodium and urea were not helpful in distinguishing intrinsic AKI from other causes. Conclusions: AKI is very common in COVID-19 and is associated with higher mortality. Characterization of AKI is warranted due to its diverse nature and clinical outcome. View Full-Text
Keywords: COVID-19; coronavirus; SARS-CoV-2; acute kidney injury; risk factors COVID-19; coronavirus; SARS-CoV-2; acute kidney injury; risk factors
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MDPI and ACS Style

Hansrivijit, P.; Gadhiya, K.P.; Gangireddy, M.; Goldman, J.D. Risk Factors, Clinical Characteristics, and Prognosis of Acute Kidney Injury in Hospitalized COVID-19 Patients: A Retrospective Cohort Study. Medicines 2021, 8, 4. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8010004

AMA Style

Hansrivijit P, Gadhiya KP, Gangireddy M, Goldman JD. Risk Factors, Clinical Characteristics, and Prognosis of Acute Kidney Injury in Hospitalized COVID-19 Patients: A Retrospective Cohort Study. Medicines. 2021; 8(1):4. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8010004

Chicago/Turabian Style

Hansrivijit, Panupong; Gadhiya, Kinjal P.; Gangireddy, Mounika; Goldman, John D. 2021. "Risk Factors, Clinical Characteristics, and Prognosis of Acute Kidney Injury in Hospitalized COVID-19 Patients: A Retrospective Cohort Study" Medicines 8, no. 1: 4. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8010004

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