COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study.

Autor: Martínez-Sánchez FD; Department of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, México.; Facultad de Medicina, Universidad Nacional Autonoma de Mexico, México., Bastida-Castro LA; Department of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, México., Torres-Cuevas JL; Department of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, México., Vasquez-Vasquez JA; Department of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, México.; Facultad de Medicina, Universidad Nacional Autonoma de Mexico, México., Diaz-Jarquin A; Department of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, México., Moreno-Novales R; Department of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, México., Balderas-Juarez J; Department of Nephrology, Hospital General Dr. Manuel Gea Gonzalez, Ciudad de México, México., Salinas-Ramírez MA; Department of Nephrology, Hospital General Dr. Manuel Gea Gonzalez, Ciudad de México, México., Hernández-Castillo JL; Department of Nephrology, Hospital General Dr. Manuel Gea Gonzalez, Ciudad de México, México., Tenorio-Aguirre EK; Department of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
Jazyk: angličtina
Zdroj: Canadian journal of kidney health and disease [Can J Kidney Health Dis] 2024 Nov 10; Vol. 11, pp. 20543581241297369. Date of Electronic Publication: 2024 Nov 10 (Print Publication: 2024).
DOI: 10.1177/20543581241297369
Abstrakt: Background: Acute kidney injury (AKI) is a frequent complication associated with severe COVID-19 and has been linked to increased mortality. While vaccination against SARS-CoV-2 has shown effectiveness in reducing severe COVID-19 outcomes, its impact on the development of AKI among hospitalized patients remains unclear.
Objective: To evaluate the effect of SARS-CoV-2 vaccination on the incidence and severity of AKI and 28-day mortality among hospitalized patients with severe COVID-19.
Design: Retrospective case-control study.
Setting: Conducted at the Internal Medicine Department of Hospital General Dr. Manuel Gea González, Mexico, from April 2020 to December 2021.
Patients: 413 patients over 18 with confirmed severe COVID-19 were included. Patients were categorized based on their vaccination status before COVID-19 infection.
Measurements: Key outcomes included the incidence of AKI, progression to AKI stage 3, and 28-day mortality. AKI was defined according to the KDIGO criteria.
Methods: Data were analyzed using univariate and logistic regression models to assess the association between vaccination status and the studied outcomes. Covariates included age, sex, BMI, type 2 diabetes, hypertension, and inflammatory markers.
Results: Among the 413 patients, 70% developed AKI, with a median hospital stay of 10 days (range 6-17). Vaccinated patients had a significantly lower incidence of AKI compared with nonvaccinated patients (48.7% vs 74.9%; P < .001). After adjusting for confounding factors, vaccination was associated with lower odds of AKI (OR: 0.252, 95% CI: 0.140-0.452), AKI stage 3 (OR: 0.448, 95% CI: 0.205-0.981), and 28-day mortality (OR: 0.187, 95% CI: 0.064-0.544).
Limitations: As a single-center retrospective study, generalizability is limited. In addition, vaccination data were obtained from medical records, and the completeness of vaccination could not be independently verified.
Conclusions: SARS-CoV-2 vaccination was independently associated with a reduced risk of AKI, AKI stage 3, and 28-day mortality in hospitalized patients with severe COVID-19. These findings highlight the potential protective effects of vaccination against severe kidney complications in this population.
Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2024.)
Databáze: MEDLINE