Development of a Risk Score for AKI onset in COVID-19 Patients: COV-AKI Score.

Autor: Palomba H; Hospital Vila Nova Star - ICU and Critical Care Nephrology Department, Rua Dr. Alceu de Campos Rodrigues 126, São Paulo, Brazil. henriquepalomba@gmail.com., Cubos D; Hospital Vila Nova Star - ICU and Critical Care Nephrology Department, Rua Dr. Alceu de Campos Rodrigues 126, São Paulo, Brazil.; Instituto D'Or de Pesquisa e Ensino, Avenida República do Líbano 611, São Paulo, Brazil., Bozza F; Instituto D'Or de Pesquisa e Ensino, Avenida República do Líbano 611, São Paulo, Brazil.; Instituto Nacional de Infectologia Evandro Chagas Fundação Oswaldo Cruz FIOCRUZ, Avenida Brasil 4365 , Rio de Janeiro, Brazil., Zampieri FG; Hospital Vila Nova Star - ICU and Critical Care Nephrology Department, Rua Dr. Alceu de Campos Rodrigues 126, São Paulo, Brazil., Romano TG; Hospital Vila Nova Star - ICU and Critical Care Nephrology Department, Rua Dr. Alceu de Campos Rodrigues 126, São Paulo, Brazil.; Instituto D'Or de Pesquisa e Ensino, Avenida República do Líbano 611, São Paulo, Brazil.; Hospital São Luiz Itaim - Oncologic Critical Care Department, Rua Dr. Alceu de Campos Rodrigues 95, São Paulo, Brazil.; ABC Medical School Nephrology Department Assistant Professor, Avenida Príncipe de Gales 821, Santo André, Brazil.
Jazyk: angličtina
Zdroj: BMC nephrology [BMC Nephrol] 2023 Mar 02; Vol. 24 (1), pp. 46. Date of Electronic Publication: 2023 Mar 02.
DOI: 10.1186/s12882-023-03095-4
Abstrakt: Purpose: Acute Kidney Injury (AKI) in COVID-19 patients is associated with increased morbidity and mortality. In the present study, we aimed to develop a prognostic score to predict AKI development in these patients.
Materials and Methods: This was a retrospective observational study of 2334 COVID 19 patients admitted to 23 different hospitals in Brazil, between January 10th and August 30rd, 2020. The primary outcome of AKI was defined as any increase in serum creatinine (SCr) by 0.3 mg/dL within 48 h or a change in SCr by ≥ 1.5 times of baseline within 1 week, based on Kidney Disease Improving Global Outcomes (KDIGO) guidelines. All patients aged ≥ 18 y/o admitted with confirmed SARS-COV-2 infection were included. Discrimination of variables was calculated by the Receiver Operator Characteristic Curve (ROC curve) utilizing area under curve. Some continuous variables were categorized through ROC curve. The cutoff points were calculated using the value with the best sensitivity and specificity.
Results: A total of 1131 patients with COVID-19 admitted to the ICU were included. Patients mean age was 52 ± 15,8 y/o., with a prevalence of males 60% (n = 678). The risk of AKI was 33% (n = 376), 78% (n = 293) of which did not require dialysis. Overall mortality was 11% (n = 127), while for AKI patients, mortality rate was 21% (n = 80). Variables selected for the logistic regression model and inclusion in the final prognostic score were the following: age, diabetes, ACEis, ARBs, chronic kidney disease and hypertension.
Conclusion: AKI development in COVID 19 patients is accurately predicted by common clinical variables, allowing early interventions to attenuate the impact of AKI in these patients.
(© 2023. The Author(s).)
Databáze: MEDLINE
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