Long term impact of the COVID-19 associated AKI: the relationship between kidney recovery and mortality in a 10-month follow-up cohort study

Autor: Azar Hadadi, Hossein Farrokhpour, Sina Rashedi, Samira Kafan, Mehran Sotoudehnia, Hormat Rahimzadeh, Seidzia Tabatabaei, Effat Razeghi, Ziba Aghsaeifard
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Kidney & Blood Pressure Research (2022)
Druh dokumentu: article
ISSN: 1420-4096
1423-0143
DOI: 10.1159/000524451
Popis: Abstract Introduction: Corona Virus-2019 (COVID-19) associated acute kidney injury (AKI) and its short and mid-term effect on kidney has been well established in the previous literature, indicating a high number of AKI in hospitalized patients associated with high rates of mortality, followed by high rates of unresolved kidney injury at the time of discharge. However, the long-term impact of AKI and its resulting lack of recovery at discharge has not been investigated. Herein, we sought to explore the possible relationship between AKI and unresolved kidney injury and post-discharge mortality. Method: In this cohort study, patients hospitalized with COVID-19 who survived to the discharge were followed for a median of 9.6 months. AKI during hospitalization based on the staging according to KDIGO criteria and Kidney injury status at the time of discharge and other comorbidities and mortality during the follow-up period, were recorded. Using Cox proportional hazards regression, the desired association was investigated after adjustment for potential confounders. Result: Among 1017 discharged patients, 298 patients (29.3%) experienced AKI during hospitalization according to KDIGO criteria, of whom 178 patients (59.7%) were diagnosed with unresolved kidney injury at the time of discharge. After adjusting for potential confounders, Cox regression indicated that AKI stage 3 (HR: 4.56, 95% CI: 1.89-10.99, p=0.001) and unresolved kidney injury at the time of discharge (HR: 2.09, 95% CI: 1.18-3.73, p=0.011) were significantly associated with mortality during the post-discharge period. Additionally, Kaplan-Meier curves for overall survival indicated an increased risk of mortality in patients with stage 2, stage 3 AKI, and unresolved kidney injury at the time of discharge. ( P
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