Impact of hospital-acquired acute kidney injury on Covid-19 outcomes in patients with and without chronic kidney disease: a multicenter retrospective cohort study

Autor:	Öztürk S; Department of Nephrology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey, Turgutalp K; Department of Internal Medicine, Division of Nephrology, Mersin University Faculty of Medicine, Training and Research Hospital, Mersin, Turkey, Arıcı M; Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey, Çetinkaya H; Department of Nephrology, Sultan 2. Abdulhamid Han Training and Research Hospital, University of Health Sciences, İstanbul, Turkey, Altıparmak MR; Department of Internal Medicine, Division of Nephrology, Cerrahpaşa Faculty of Medicine, İstanbul University–Cerrahpaşa, İstanbul, Turkey, Aydın Z; Department of Nephrology, Darıca Farabi Training and Research Hospital, Kocaeli, Turkey, Soypaçacı Z; Department of Internal Medicine, Division of Nephrology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey, Bora F; Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey, Kara E; Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey, Cebeci E; Department of Nephrology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey, Özler TE; Department of Internal Medicine, Division of Nephrology, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, İstanbul, Turkey, Dölarslan ME; Department of Nephrology, Trabzon Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey, Sipahi S; Department of Internal Medicine, Division of Nephrology, Sakarya University Training and Research Hospital, Sakarya, Turkey, Ayar Y; Department of Nephrology, Bursa City Hospital, Bursa, Turkey, Şahin İ; Department of Internal Medicine, Division of Nephrology, Turgut Özal Medical Center, İnönü University Faculty of Medicine, Malatya, Turkey, Bakırdöğen S; Department of Internal Medicine, Division of Nephrology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey, İslam M; Department of Nephrology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey, Görgülü N; Department of Internal Medicine, Division of Nephrology, Bağcılar Training and Research Hospital, University of Health Sciences, İstanbul, Turkey, Öğütmen MB; Department of Nephrology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, İstanbul, Turkey, Şengül E; Department of Nephrology, Kocaeli Derince Training and Research Hospital, University of Health Sciences, Kocaeli, Turkey, Güngör Ö; Department of Nephrology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey, Seyahi N; Department of Internal Medicine, Division of Nephrology, Cerrahpaşa Faculty of Medicine, İstanbul University–Cerrahpaşa, İstanbul, Turkey, Tokgöz B; Department of Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey, Odabaş AR; Department of Nephrology, Sultan 2. Abdulhamid Han Training and Research Hospital, University of Health Sciences, İstanbul, Turkey, Tonbul HZ; Department of Nephrology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey, Sezer S; Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Atılım University, Ankara, Turkey, Yıldız A; Department of Internal Medicine, Division of Nephrology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey, Ateş K; Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkey
Jazyk:	angličtina
Zdroj:	Turkish journal of medical sciences [Turk J Med Sci] 2021 Jun 28; Vol. 51 (3), pp. 947-961. Date of Electronic Publication: 2021 Jun 28.
DOI:	10.3906/sag-2011-169
Abstrakt:	Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and Methods: HA-AKI development was assessed in a group of stage 3–5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47–73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9–44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9–33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients. Competing Interests: The authors declare that they have no conflicts of interest. (This work is licensed under a Creative Commons Attribution 4.0 International License.)
Databáze:	MEDLINE
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