Related Experiment Video

Updated: Jan 18, 2026

Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury
07:03

Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury

Published on: February 15, 2022

1.7K

Acute kidney injury and in-hospital mortality in COVID-19: a causal analysis using directed acyclic graphs

Paola Andrea Gallego Aristizabal1,2, Tania Paola Lujan Chavarría3,4, Joaquín Rodelo-Ceballos5,4

  • 1Department of Internal Medicine, Faculty of Medicine, Universidad de Antioquia, Carrera 73 # 53-93, Medellín, Colombia. paolagallego383@gmail.com.

Journal of Nephrology
|September 8, 2025
PubMed

Insights

Acute kidney injury (AKI) significantly increases mortality risk in COVID-19 patients. This study used directed acyclic graphs to confirm AKI

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Epidemiology

Background:

  • Acute kidney injury (AKI) is a frequent complication in COVID-19 patients, linked to higher mortality.
  • The independent impact of AKI on COVID-19 mortality requires further clarification.

Purpose of the Study:

  • To assess the independent association between AKI and mortality in COVID-19 patients.
  • To utilize a directed acyclic graph (DAG) approach for causal inference.

Main Methods:

  • A retrospective, multicenter cohort study included 1722 patients from June 2020 to April 2022.
  • AKI was diagnosed using KDIGO criteria.
  • A DAG was constructed to guide confounder adjustment, followed by Poisson regression to estimate mortality risk.

Main Results:

  • 30.7% of patients developed AKI, with significantly higher mortality (58.1%) compared to those without AKI (19.6%).
  • Adjusted incidence rate ratios (IRRs) for in-hospital mortality were 1.25 (Stage 1), 1.62 (Stage 2), and 1.64 (Stage 3) for AKI stages.
  • DAG analysis identified a minimal sufficient adjustment set for robust causal estimation.

Conclusions:

  • AKI is an independent predictor of increased mortality in COVID-19 patients.
  • The study demonstrates the utility of DAGs in strengthening causal inference in observational studies.
  • DAGs offer a rigorous method to identify confounders and avoid mediator bias, enhancing the validity of findings when RCTs are not feasible.
Abstract

Keywords:
Acute kidney injuryCOVID-19Causal inferenceDirected acyclic graphsMortalityRisk factors

More Related Videos

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

4.9K
Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research03:13

Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research

Published on: November 3, 2023

2.9K

Related Concept Videos

Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
586
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
910
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
271
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
297
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
828
Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
398