Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019
Sébastien Rubin,Arthur Orieux,Renaud Prevel,Antoine Garric,Marie Lise Bats,Sandrine Dabernat,Fabrice Camou,Olivier Guisset,Nahema Issa,Gaelle Mourissoux,Antoine Dewitte,Olivier Joannes-Boyau,Catherine Fleureau,Hadrien Rozé,Cédric Carrié,Laurent Petit,Benjamin Clouzeau,Charline Sazio,Hoang Nam Bui,Odile Pillet,Claire Rigothier,Frédéric Vargas,Christian Combe,Didier Gruson,Alexandre Boyer +24 more
TLDR
Severe COVID-19-associated acute kidney injury (AKI) is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria.Abstract:
Background Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) frequency, severity and characterization in critically ill patients has not been reported. Methods Single-centre cohort performed from 3 March 2020 to 14 April 2020 in four intensive care units in Bordeaux University Hospital, France. All patients with COVID-19 and pulmonary severity criteria were included. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterization (transient versus persistent AKI; proteinuria, haematuria and glycosuria) and short-term outcomes were evaluated. Results Seventy-one patients were included, with basal serum creatinine (SCr) of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median [interquartile range (IQR)] follow-up was 17 (12-23) days. AKI developed in a total of 57/71 (80%) patients, with 35% Stage 1, 35% Stage 2 and 30% Stage 3 AKI; 10/57 (18%) required renal replacement therapy (RRT). Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median (IQR) urine protein/creatinine of 82 (54-140) (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20, indicating predominant tubulointerstitial injury. Only two (4%) patients had glycosuria. At Day 7 after onset of AKI, six (11%) patients remained dependent on RRT, nine (16%) had SCr >200 µmol/L and four (7%) had died. Day 7 and Day 14 renal recovery occurred in 28% and 52%, respectively. Conclusion Severe COVID-19-associated AKI is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria.read more
Citations
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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Journal ArticleDOI
Outcomes Among Patients Hospitalized With COVID-19 and Acute Kidney Injury.
Jia H. Ng,Jamie S. Hirsch,Jamie S. Hirsch,Azzour D. 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 Barnett,Alessandro G. Bellucci,Madhu 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 Nair,Jia Hwei Ng,Rushang Parikh,Mala Sachdeva,Richard Schwarz,Pravin C. Singhal,Nupur N. Uppal +37 more
TL;DR: The goal of this study was to investigate the survival and kidney outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) and to observe greater risks for in-hospital death for patients with AKI 1-3 and AKI 3D.
Journal ArticleDOI
Outcomes for Patients With COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis
Shelief Y Robbins-Juarez,Long Qian,Kristen L. King,Jacob S. Stevens,S. Ali Husain,Jai Radhakrishnan,Sumit Mohan +6 more
TL;DR: Kidney dysfunction is common among patients with COVID-19, and patients who develop AKI have inferior outcomes, although there was considerable heterogeneity across studies and among different regions in the world.
Journal ArticleDOI
Acute Kidney Injury in a National Cohort of Hospitalized US Veterans with COVID-19.
Benjamin Bowe,Benjamin Bowe,Miao Cai,Yan Xie,Yan Xie,Andrew K. Gibson,Geetha Maddukuri,Ziyad Al-Aly +7 more
TL;DR: Both geographic and temporal variabilities were predominately explained by percentages of Blacks, and older age, Black race, male gender, obesity, diabetes, hypertension, and lower eGFR were significant predictors of AKI during hospitalization with COVID-19.
Journal ArticleDOI
The Prevalence of Acute Kidney Injury in Patients Hospitalized With COVID-19 Infection: A Systematic Review and Meta-analysis.
Samuel A. Silver,William Beaubien-Souligny,Prakesh S. Shah,Shai Harel,Daniel Blum,Teruko Kishibe,Alejandro Meraz-Munoz,Ron Wald,Ziv Harel +8 more
TL;DR: The pooled prevalence of AKI and receipt of KRT among hospitalized patients with COVID-19 was determined using a random effects model and significant heterogeneity among the included studies remained unaccounted for in sub-group analysis.
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