Association of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry

Autor: Sagar Ranka, Anjali Rao, Purav Mody, Nicholas S. Hendren, Anna Rosenblatt, S. Susan Hedayati, Sandeep R Das, Wally Omar, Heather M. Alger, Rohan Khera, Colby Ayers, Kamal Gupta, Christopher DeFilippi, Christine Rutan, James A. de Lemos
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
Time Factors
Population
030232 urology & nephrology
030204 cardiovascular system & hematology
urologic and male genital diseases
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Disease registry
COVID‐19
Risk Factors
Internal medicine
Cause of Death
medicine
Humans
Myocardial infarction
Registries
Renal Insufficiency
Chronic
education
Cause of death
Original Research
Aged
Aged
80 and over
education.field_of_study
Kidney in Cardiovascular Disease
business.industry
Hazard ratio
Acute kidney injury
COVID-19
Middle Aged
medicine.disease
Prognosis
mortality
female genital diseases and pregnancy complications
United States
Hospitalization
acute kidney injury
Cardiovascular Diseases
Heart failure
Female
Mortality/Survival
Cardiology and Cardiovascular Medicine
business
chronic kidney disease
Kidney disease
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
Popis: Background Emerging evidence links acute kidney injury (AKI) in patients with COVID‐19 with higher mortality and respiratory morbidity, but the relationship of AKI with cardiovascular disease outcomes has not been reported in this population. We sought to evaluate associations between chronic kidney disease (CKD), AKI, and mortality and cardiovascular outcomes in patients hospitalized with COVID‐19. Methods and Results In a large multicenter registry including 8574 patients with COVID‐19 from 88 US hospitals, data were collected on baseline characteristics and serial laboratory data during index hospitalization. Primary exposure variables were CKD (categorized as no CKD, CKD, and end‐stage kidney disease) and AKI (classified into no AKI or stages 1, 2, or 3 using a modification of the Kidney Disease Improving Global Outcomes guideline definition). The primary outcome was all‐cause mortality. The key secondary outcome was major adverse cardiac events, defined as cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, new‐onset nonfatal heart failure, and nonfatal cardiogenic shock. CKD and end‐stage kidney disease were not associated with mortality or major adverse cardiac events after multivariate adjustment. In contrast, AKI was significantly associated with mortality (stage 1 hazard ratio [HR], 1.72 [95% CI, 1.46–2.03]; stage 2 HR, 1.83 [95% CI, 1.52–2.20]; stage 3 HR, 1.69 [95% CI, 1.44–1.98]; versus no AKI) and major adverse cardiac events (stage 1 HR, 2.17 [95% CI, 1.74–2.71]; stage 2 HR, 2.70 [95% CI, 2.07–3.51]; stage 3 HR, 3.06 [95% CI, 2.52–3.72]; versus no AKI). Conclusions This large study demonstrates a significant association between AKI and all‐cause mortality and, for the first time, major adverse cardiovascular events in patients hospitalized with COVID‐19.
Databáze: OpenAIRE
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