Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology

Autor: Ebru Gok Oguz, Gulsah Boz, Feyza Bora, Numan Gorgulu, Mahmut Gok, Enver Yuksel, Serhat Karadag, Dilek Guven Taymez, Dilek Gibyeli Genek, Ekrem Kara, Eda Altun, Serhan Tuglular, Sultan Ozkurt, Melike Betul Ogutmen, Zeki Aydin, Elbis Ahbap, Belda Dursun, Zeki Soypacaci, Mehmet Polat, İdris Şahin, Mahmud Islam, Savas Ozturk, Sinan Trabulus, Murside Esra Dolarslan, Erkan Sengul, Esra Akcali, Hamad Dheir, Nurhan Seyahi, Elif Ari Bakir, Ozgur Akin Oto, Hakki Arikan, Tuncay Sahutoglu, Yavuz Ayar, Özant Helvacı, Zehra Eren, Ilhan Kurultak, Sumeyra Koyuncu, Bulent Tokgoz, Hulya Colak
Přispěvatelé: ALKÜ, Fakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Arikan, Hakki, Ozturk, Savas, Tokgoz, Bulent, Dursun, Belda, Seyahi, Nurhan, Trabulus, Sinan, Islam, Mahmud, Ayar, Yavuz, Gorgulu, Numan, Karadag, Serhat, Gok, Mahmut, Akcali, Esra, Bora, Feyza, Aydin, Zeki, Altun, Eda, Ahbap, Elbis, Polat, Mehmet, Soypacaci, Zeki, Oguz, Ebru Gok, Koyuncu, Sumeyra, Colak, Hulya, Sahin, Idris, Dolarslan, Murside Esra, Helvaci, Ozant, Kurultak, Ilhan, Eren, Zehra, Dheir, Hamad, Ogutmen, Melike Betul, Taymez, Dilek Guven, Genek, Dilek Gibyeli, Ozkurt, Sultan, Bakir, Elif Ari, Yuksel, Enver, Sahutoglu, Tuncay, Oto, Ozgur Akin, Boz, Gulsah, Sengul, Erkan, Kara, Ekrem, Tuglular, Serhan, MÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Gibeyli Genek, Dilek, RTEÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Turkey
retrospective study
proportional hazards model
Comorbidity
urologic and male genital diseases
Biochemistry
intensive care unit
Severity of Illness Index
DISEASE
law.invention
hazard ratio
Medical Conditions
Endocrinology
CLINICAL CHARACTERISTICS
middle aged
Hospital Mortality
education.field_of_study
adult
Hazard ratio
Acute kidney injury
clinical trial
cohort analysis
WUHAN
aged
risk factor
Nephrology
Creatinine
diabetes mellitus
Medicine
disease severity
Infection
Wuhan
medicine.medical_specialty
hypertension
Death Rates
Endocrine Disorders
Science
causal attribution
complication
Article
Population Metrics
turkey (bird)
Severity of illness
CKD
Renal Diseases
Ckd
Humans
human
education
Retrospective Studies
Biology and Life Sciences
Covid 19
sex ratio
medicine.disease
major clinical study
mortality
DIALYSIS PATIENTS
Health Care
hospital discharge
multicenter study
TRANSPLANT
sex factor
Health Care Facilities
observational study
Biomarkers
Dialysis Patients
Viral Diseases
mortality rate
Transplant
law
Risk Factors
INFECTION
Chronic Kidney Disease
Medicine and Health Sciences
Disease
Multidisciplinary
Mortality rate
chronic kidney failure
Acute Kidney Injury
Intensive care unit
Hospitals
virology
Hospitalization
hospital patient
Intensive Care Units
Infectious Diseases
female
Anatomy
Research Article
Population
coronavirus disease 2019
Sex Factors
acute kidney failure
blood
Internal medicine
medicine
Mortality
outcome assessment
Proportional Hazards Models
Population Biology
L-Lactate Dehydrogenase
business.industry
lactate dehydrogenase blood level
isolation and purification
SARS-CoV-2
disease association
COVID-19
Kidneys
lactate dehydrogenase
Renal System
Metabolic Disorders
pathology
business
Kidney disease
in-hospital mortality
Zdroj: PLoS ONE
PLoS ONE, Vol 16, Iss 8 (2021)
PLoS ONE, Vol 16, Iss 8, p e0256023 (2021)
DOI: 10.1371/journal.pone.0256023
Popis: BackgroundAcute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI.MethodsIn this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients.ResultsThe median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0–1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04–2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06–2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08–3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05–2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25–3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44–3.51], p = 0.0001) were independent predictors of in-hospital mortality.ConclusionsAdvanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.
Databáze: OpenAIRE
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