Outcomes Among Patients Hospitalized With COVID-19 and Acute Kidney Injury
| Autor: | Jia H. Ng, Jamie S. Hirsch, Azzour Hazzan, Rimda Wanchoo, Hitesh H. Shah, Deepa A. Malieckal, Daniel W. Ross, Purva Sharma, Vipulbhai Sakhiya, Steven Fishbane, Kenar D. Jhaveri, Mersema Abate, Hugo Paz Andrade, Richard L. Barnett, Alessandro Bellucci, Madhu C. Bhaskaran, Antonio G. Corona, Bessy Suyin Flores Chang, Mark Finger, Michael Gitman, Candice Halinski, Shamir Hasan, Azzour D. Hazzan, Susana Hong, Yuriy Khanin, Aireen Kuan, Varun Madireddy, Deepa Malieckal, Abdulrahman Muzib, Gayatri Nair, Vinay V. Nair, Jia Hwei Ng, Rushang Parikh, Mala Sachdeva, Richard Schwarz, Pravin C. Singhal, Nupur N. Uppal |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
urogenital system business.industry medicine.medical_treatment 030232 urology & nephrology Acute kidney injury Renal function Retrospective cohort study urologic and male genital diseases medicine.disease Logistic regression female genital diseases and pregnancy complications 03 medical and health sciences 0302 clinical medicine Nephrology Internal medicine medicine Observational study 030212 general & internal medicine Risk factor business Dialysis Kidney disease |
| Zdroj: | American Journal of Kidney Diseases |
| ISSN: | 0272-6386 |
| Popis: | Rationale & Objective Outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) are not well understood. The goal of this study was to investigate the survival and kidney outcomes of these patients. Study Design Retrospective cohort study. Setting & Participants Patients (aged ≥18 years) hospitalized with COVID-19 at 13 hospitals in metropolitan New York between March 1, 2020, and April 27, 2020, followed up until hospital discharge. Exposure AKI. Outcomes Primary outcome: in-hospital death. Secondary outcomes: requiring dialysis at discharge, recovery of kidney function. Analytical Approach Univariable and multivariable time-to-event analysis and logistic regression. Results Among 9,657 patients admitted with COVID-19, the AKI incidence rate was 38.4/1,000 patient-days. Incidence rates of in-hospital death among patients without AKI, with AKI not requiring dialysis (AKI stages 1-3), and with AKI receiving dialysis (AKI 3D) were 10.8, 31.1, and 37.5/1,000 patient-days, respectively. Taking those without AKI as the reference group, we observed greater risks for in-hospital death for patients with AKI 1-3 and AKI 3D (HRs of 5.6 [95% CI, 5.0-6.3] and 11.3 [95% CI, 9.6-13.1], respectively). After adjusting for demographics, comorbid conditions, and illness severity, the risk for death remained higher among those with AKI 1-3 (adjusted HR, 3.4 [95% CI, 3.0-3.9]) and AKI 3D (adjusted HR, 6.4 [95% CI, 5.5-7.6]) compared with those without AKI. Among patients with AKI 1-3 who survived, 74.1% achieved kidney recovery by the time of discharge. Among those with AKI 3D who survived, 30.6% remained on dialysis at discharge, and prehospitalization chronic kidney disease was the only independent risk factor associated with needing dialysis at discharge (adjusted OR, 9.3 [95% CI, 2.3-37.8]). Limitations Observational retrospective study, limited to the NY metropolitan area during the peak of the COVID-19 pandemic. Conclusions AKI in hospitalized patients with COVID-19 was associated with significant risk for death. |
| Databáze: | OpenAIRE |
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