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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Acute kidney injury associated with COVID-19: A retrospective cohort study
Nitin V Kolhe1,2, Richard J Fluck1,2, Nicholas M Selby1,2
1Department of Nephrology, University Hospitals of Derby and Burton, Royal Derby Hospital, Derby, United Kingdom.
Plos Medicine
|October 30, 2020
Summary
Patients with Coronavirus Disease 2019 (COVID-19) experienced a high incidence of acute kidney injury (AKI). COVID-19-associated AKI significantly increased mortality risk compared to COVID-19 without AKI or AKI from other causes.
Area of Science:
- Nephrology and Infectious Diseases
- Epidemiology of viral infections and kidney complications
Background:
- Initial reports suggest a high incidence of acute kidney injury (AKI) in Coronavirus Disease 2019 (COVID-19).
- Further data are needed to establish COVID-19 as an independent risk factor for AKI and to differentiate COVID-19-associated AKI from other causes.
Purpose of the Study:
- To investigate the relationship between COVID-19, AKI, and patient outcomes.
- To determine if COVID-19 is an independent risk factor for AKI.
- To compare characteristics and outcomes of COVID-19-associated AKI with AKI in COVID-19-negative patients.
Main Methods:
- Retrospective cohort study of 4,759 hospitalized patients tested for COVID-19 between March 5 and May 12, 2020.
- Data extracted from electronic health records, linked to laboratory systems.
- Primary outcome: AKI. Secondary outcomes: in-hospital mortality, need for ventilatory support, ICU admission, length of stay.
Main Results:
- AKI incidence was 26.2% in COVID-19 patients versus 12.4% in COVID-19-negative patients.
- COVID-19-associated AKI was linked to higher mortality (60.5% vs. 27.4% in non-AKI COVID-19 patients; 60.5% vs. 27.6% in AKI controls).
- AKI was an independent predictor of mortality in COVID-19 patients (OR 3.27); COVID-19 itself was also an independent predictor of death (OR 3.80).
Conclusions:
- A high incidence of AKI was observed in COVID-19 patients, significantly increasing mortality risk.
- COVID-19-associated AKI demonstrated a 3-fold higher odds of death compared to COVID-19 without AKI.
- Patients with COVID-19 require close monitoring for AKI development, and preventive measures should be implemented.
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