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Many people who develop COVID-19 suffer from kidney damage or acute kidney injury (AKI). The researchers recently evaluated the incidence, risk factors, and prognosis of AKI in adults with COVID-19. Their results will appear in an upcoming issue of CJASN.
The study was conducted at Tongji Hospital in Wuhan, China, which was contracted by the local government to treat severe COVID-19 cases. Investigator led by Gang Xu, Ph.D. and Shuwang Ge, MD, analyzed information on 1,392 patients who tested positive for the virus that causes COVID-19.
The team found that AKI is uncommon in patients with COVID-19, but is associated with a high risk of hospital mortality. Seven percent of patients developed AKI during their hospital stay, many within seven days of admission. The in-hospital mortality rate was 10% in patients without AKI versus 72% in patients with AKI. After adjusting for possible confounding factors, AKI was associated with a five times higher probability of death in hospital. The risk of death was also higher with increasing severity of AKI.
Factors associated with higher risk of AKI included severe COVID-19 illness, high levels of creatinine in the blood (an indicator of kidney dysfunction), low blood levels of certain immune cells, and high blood levels of a protein fragment, which indicates increased clot formation and breakdown.
“Prior to this study, there was limited information on epidemiological features and outcomes related to AKI in patients with COVID-19,” said Dr. Xu. “Our results indicate that AKI is strongly associated with mortality and that careful monitoring of AKI early in the course of infection is required.”
An accompanying editorial notes that additional studies are needed to investigate why AKI is associated with such a high risk of premature death in patients with COVID-19.
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“Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Adult Patients with Coronavirus Disease 2019”, CJASN, DOI: 10.2215 / CJN.04650420
“COVID 19-Associated AKI: A Developing Image”, DOI: 10.2215 / CJN.13600820
Provided by the American Society of Nephrology
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