Related Experiment Video
Updated: Jun 22, 2025
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Outcome Comparison in Hospitalized COVID-19 Patients With and Without AKI
Sanjivani Shrestha1, Yani Zhang2, Wajehe Najafi2
1Department of Nephrology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Insights
Hospitalized COVID-19 patients with Acute Kidney Injury (AKI) faced significantly higher in-patient mortality and critical care needs. This study highlights the severe impact of AKI on COVID-19 outcomes, particularly in a predominantly Black patient population.
Area of Science:
- Nephrology
- Infectious Diseases
- Critical Care Medicine
Background:
- Hospitalized patients with COVID-19 exhibit a higher incidence of Acute Kidney Injury (AKI) compared to non-COVID patients.
- Previous research indicates a significant association between AKI and increased mortality rates in COVID-19 patients.
Purpose of the Study:
- To investigate the outcomes of COVID-19-associated AKI in a predominantly Black patient population.
- To compare outcomes between COVID-19 patients with and without AKI during hospitalization.
Main Methods:
- Retrospective cohort study of 1107 adult patients admitted with symptomatic COVID-19.
- Data collected from 9 acute care facilities within the MedStar Health system.
- Follow-up extended to 3 months post-discharge, analyzing inpatient mortality, ICU admission, intubation, and renal function.
Main Results:
- AKI incidence was 35% among hospitalized COVID-19 patients; 74% of AKI patients were African American.
- In-patient mortality was 41.9% in the AKI group versus 9.9% in the non-AKI group.
- COVID-19 patients with AKI had significantly higher risks of mortality (OR 4.71), ICU admission (OR 4.27), and intubation (OR 6.18).
Conclusions:
- Acute Kidney Injury in hospitalized COVID-19 patients is strongly linked to increased mortality.
- AKI is associated with a greater need for intensive care unit admission and mechanical ventilation.
- These findings underscore the critical impact of AKI on COVID-19 patient outcomes.
Aim:
Patients hospitalized with COVID-19 have a higher incidence of Acute Kidney Injury (AKI) compared with non-COVID patients. Previous observational studies showed AKI in hospitalized patients with COVID-19 was associated with significant increased mortality rate. We conducted a retrospective cohort study in a large mid-Atlantic health system to investigate whether COVID-19 associated AKI during hospitalization would lead to worse outcomes in a predominant Black patient population, compared to COVID-19 without AKI.
Methods:
We reviewed health records of patients (aged≥18 years) admitted with symptomatic COVID-19 between March 5, 2020, and Jun 3, 2020, in 9 acute care facilities within the MedStar Health system. Patients were followed up until 3 months after discharge. Primary outcome was inpatient mortality. Secondary outcomes were need for ICU level of care, need for intubation, length of ICU stay, length of hospital stay, need for renal replacement therapy, recovery of renal function.
Results:
Among 1107 patients admitted with symptomatic COVID-19, the AKI incidence rate was 35 %. African American patients made up 63 % of the total patient population and 74 % of the total AKI population. Inpatient mortality in the AKI group and the non-AKI group was 163 (41.9 %) and 71 (9.9 %), respectively. COVID-19 patients with AKI had significant higher risk of in-patient mortality (OR, 4.71 [95 % CI, 3.38-6.62], P < 0.001), ICU admission (OR, 4.27 [95 % CI, 3.21-5.72], P < 0.001) and need of intubation (OR, 6.18 [95 % CI, 4.45-8.68], P < 0.001).
Conclusions:
AKI in hospitalized patients with COVID-19 was associated with higher mortality rate, need for intubation and ICU admission compared to COVID-19 patients without AKI group.
Related Concept Videos
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:10Nephrons
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...