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Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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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...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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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...
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Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

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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...
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Acute Kidney Injury II: Pathophysiology01:29

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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...
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Long-term kidney outcomes after COVID-19: a matched cohort study using the OpenSAFELY platform.

Viyaasan Mahalingasivam1,2, Bang Zheng1, Kevin Wing3

  • 1Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

The Lancet Regional Health. Europe
|September 15, 2025
PubMed
Summary

COVID-19 hospitalization significantly increases long-term kidney failure risk, especially in Black individuals. Kidney function monitoring is crucial post-discharge for those hospitalized with COVID-19.

Keywords:
CKDCOVID-19Chronic kidney diseaseESKDESRDEnd-stage kidney diseaseEnd-stage renal diseaseKidneyKidney failure

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • COVID-19 is frequently linked to acute kidney injury in hospitalized patients.
  • Long-term kidney outcomes in the general population after COVID-19 infection remain under-researched.

Purpose of the Study:

  • To investigate the association between COVID-19 and long-term kidney outcomes.
  • To assess risks stratified by hospitalization status and ethnicity.

Main Methods:

  • Population-based, matched cohort study using UK electronic health records (OpenSAFELY-TPP).
  • Comparison of individuals with and without COVID-19 using Cox models.
  • Outcomes included kidney failure, 50% kidney function reduction, and death.

Main Results:

  • COVID-19 was associated with increased kidney failure (HR 1.93).
  • Hospitalization dramatically elevated kidney failure risk (HR 7.74), persisting beyond 180 days.
  • No increased risk observed in non-hospitalized individuals (HR 0.85).
  • Higher risk in Black ethnicity (HR 4.50) compared to White ethnicity (HR 1.82).
  • Kidney failure risk remained high across COVID-19 waves for hospitalized patients.

Conclusions:

  • Hospitalization with COVID-19 leads to increased long-term kidney outcomes.
  • Significant ethnic disparities exist in kidney failure risk post-COVID-19.
  • Proactive kidney function monitoring is recommended for discharged patients, with optimized prevention strategies for vulnerable groups.