Clinical Characteristics and Outcomes of Acute Kidney Injury in Hospitalized Patients with Coronavirus Disease 2019: Experience at a Major Tertiary Care Center in Pakistan.
Sonia YaqubAmna HamidMarwah SaeedSafia AwanAisha FarooqueHameed Ullah TareenPublished in: Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia (2023)
Limited data exist on acute kidney injury (AKI) in patients hospitalized with coronavirus disease 2019 (COVID-19), its risk factors, and the outcomes from lower and middle-income countries. We determined the epidemiology of AKI and its outcomes in a retrospective observational study at a tertiary care center in Karachi, Pakistan, from October to December 2020. Demographic data, presenting clinical symptoms, laboratory results, and patient outcomes were collected from the medical records. AKI was defined according to the Kidney Disease Improving Global Outcomes criteria. Of 301 COVID-19 patients, AKI developed in 188 (62.5%). The peak stages of AKI were Stage 1 in 57%, Stage 2 in 14.9%, and Stage 3 in 27.7%. Of these, 15 (8%) required kidney replacement therapy (KRT). Patients admitted to the intensive care unit (63.8% vs. 34.5%), and those needing vasopressors (31.9% vs. 5.3%) or mechanical ventilation (25% vs. 2.7%) had a higher risk of AKI. Independent predictors of AKI were elevated blood urea nitrogen and creatinine (Cr) at presentation, mechanical ventilation, and the use of anticoagulants. AKI, the presence of proteinuria, elevated serum Cr at presentation, use of vasopressors, and a need for KRT were significantly associated with in-hospital death, and the likelihood of mortality increased with advanced stages of AKI. Compared with other countries, AKI occurred more frequently among hospitalized patients with COVID-19 in this Pakistani cohort and was associated with 7.7-fold higher odds of in-hospital death. Patients with severe AKI had a greater likelihood of mortality than those in earlier stages or without AKI.
Keyphrases
- acute kidney injury
- cardiac surgery
- coronavirus disease
- tertiary care
- mechanical ventilation
- risk factors
- intensive care unit
- healthcare
- replacement therapy
- sars cov
- acute respiratory distress syndrome
- end stage renal disease
- chronic kidney disease
- early onset
- cardiovascular events
- metabolic syndrome
- emergency department
- extracorporeal membrane oxygenation
- ejection fraction
- smoking cessation
- peritoneal dialysis
- weight loss