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The incidence, risk factors and prognosis of acute kidney injury in severe and critically ill patients with COVID-19 in mainland China: a retrospective study

Authors
  • Sang, Ling1
  • Chen, Sibei1
  • Zheng, Xia2
  • Guan, Weijie1
  • Zhang, Zhihui1
  • Liang, Wenhua1
  • Zhong, Ming3
  • Jiang, Li4
  • Pan, Chun5
  • Zhang, Wei6
  • Xia, Jiaan7
  • Chen, Nanshan8
  • Wu, Wenjuan9
  • Wu, Hongkai10
  • Xu, Yonghao1
  • Liu, Xuesong1
  • Liu, Xiaoqing1
  • He, Jianxing1
  • Li, Shiyue1
  • Zhang, Dingyu11, 12
  • And 2 more
  • 1 Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China , Guangzhou (China)
  • 2 The First Affiliated Hospital of Zhejiang University, Zhejiang, Hangzhou, China , Zhejiang (China)
  • 3 Zhongshan Hospital Fudan University, Shanghai, China , Shanghai (China)
  • 4 Xuanwu Hospital, Capital Medical University, Beijing, China , Beijing (China)
  • 5 Zhongda Hospital, Southeast University, Nanjing, China , Nanjing (China)
  • 6 Emergency Department, the 900th Hospital of Joint Service Corps of Chinese PLA, FuZhou, China , FuZhou (China)
  • 7 Department of tuberculosis, Wuhan Jinyintan Hospital, Wuhan, China , Wuhan (China)
  • 8 Department of Respiratory and Critical Care Medicine, Wuhan Jinyintan Hospital, Wuhan, China , Wuhan (China)
  • 9 Department of Critical Care Medicine, Wuhan Jinyintan Hospital, Wuhan, China , Wuhan (China)
  • 10 The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China , Guangzhou (China)
  • 11 Research Center for Translational Medicine, Wuhan Jinyintan Hospital, Wuhan, China , Wuhan (China)
  • 12 Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, China , Wuhan (China)
Type
Published Article
Journal
BMC pulmonary medicine
Publication Date
Nov 09, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12890-020-01305-5
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe clinical correlates, prognosis and determinants of acute kidney injury (AKI) in patients with coronavirus disease 2019 (Covid-19) remain largely unclear.MethodsWe retrospectively reviewed medical records of all adult patients with laboratory-confirmed Covid-19 who were admitted to the intensive care unit (ICU) between January 23rd 2020 and April 6th 2020 at Wuhan JinYinTan Hospital and The First Affiliated Hospital of Guangzhou Medical University.ResultsAmong 210 patients, 131 were males (62.4%). The median Age was 64 years (IQR: 56ā€“71). Of 92 (43.8%) patients who developed AKI during hospitalization, 13 (14.1%), 15 (16.3%) and 64 (69.6%) were classified as being at stage 1, 2 and 3, respectively. 54 patients (58.7%) received continuous renal replacement therapy. Age, sepsis, nephrotoxic drug, invasive mechanical ventilation and elevated baseline serum creatinine levels were associated with the occurrence of AKI. Renal recovery during hospitalization was identified among 16 patients with AKI (17.4%), who had a significantly shorter time from admission to AKI diagnosis, lower incidence of right heart failure and higher ratio of partial pressure of oxygen to the fraction of inspired oxygen. Of 210 patients, 93 deceased within 28 days of ICU admission. AKI stage 3, critical disease, greater Age and the lowest ratio of partial pressure of oxygen to the fraction of inspired oxygen being < 150 mmHg were independently associated with death.ConclusionsAmong patients with Covid-19, the incidence of AKI was high. Our findings of the risk factors of the development of AKI and factors associated with renal function recovery may inform clinical management of patients with critical illness of Covid-19.

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