Differences Between COVID-19-induced Acute Kidney Injury and Chronic Kidney Disease Patients

Overview

Journal J Bras Nefrol

Specialty Nephrology

Date 2022 Mar 8

PMID 35258071

Authors

Gustavo Aroca-Martinez

Carlos G Musso

Lil Avendano-Echavez

Maria Velez-Verbel

Stefani Chartouni-Narvaez

Sandra Hernandez

Mauricio Andres Hinojosa-Vidal

Zilac Espitaleta

Andres Cadena-Bonfanti

Affiliations

Soon will be listed here.

Abstract

Introduction: This article describes the main differences between COVID-19-induced acute kidney injury (AKI-COVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKI-CKD) treated in a high complexity clinic in Barranquilla (Colombia).

Material And Methods: The patients included in this study (n: 572) were those with a positive diagnosis of COVID-19 confirmed by detection of a positive PCR for SARS-CoV-2. Of these patients, 188 developed AKI during their hospital stay. Patients' epidemiological data, serum parameters, and clinical frailty status were recorded. Statistical analysis and comparison among AKI-NRF, AKI-CKD, and non-AKI patients were performed.

Results: The incidence of COVID-19-induced AKI was 33%, with the majority classified as AKIN 1, 16% requiring renal replacement therapy, and AKI-COVID19 mortality of 68%. A significantly higher prevalence of hypertension, cardiac disease, and serum reactive C-protein and lower albumin values in AKI-CKD patients was recorded. Mortality rate, invasive ventilation requirement, and D-dimer levels were significantly higher in AKI-NRF patients.

Conclusion: Different clinical patterns between AKI-NRF and AKI-CKD were documented.

Citing Articles

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COVID-19-induced acute kidney injury and chronic kidney disease: comment.

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References

Golmai P, Larsen C, DeVita M, Wahl S, Weins A, Rennke H . Histopathologic and Ultrastructural Findings in Postmortem Kidney Biopsy Material in 12 Patients with AKI and COVID-19. J Am Soc Nephrol. 2020; 31(9):1944-1947. PMC: 7461690. DOI: 10.1681/ASN.2020050683. View

Hassanein M, Radhakrishnan Y, Sedor J, Vachharajani T, Vachharajani V, Augustine J . COVID-19 and the kidney. Cleve Clin J Med. 2020; 87(10):619-631. DOI: 10.3949/ccjm.87a.20072. View

Corman V, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu D . Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020; 25(3). PMC: 6988269. DOI: 10.2807/1560-7917.ES.2020.25.3.2000045. View

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J . Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-1069. PMC: 7042881. DOI: 10.1001/jama.2020.1585. View

Pujadas E, Chaudhry F, McBride R, Richter F, Zhao S, Wajnberg A . SARS-CoV-2 viral load predicts COVID-19 mortality. Lancet Respir Med. 2020; 8(9):e70. PMC: 7836878. DOI: 10.1016/S2213-2600(20)30354-4. View

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z . Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-1062. PMC: 7270627. DOI: 10.1016/S0140-6736(20)30566-3. View

Sang L, Chen S, Zheng X, Guan W, Zhang Z, Liang W . 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. BMC Pulm Med. 2020; 20(1):290. PMC: 7649893. DOI: 10.1186/s12890-020-01305-5. View

Ruan Q, Yang K, Wang W, Jiang L, Song J . Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020; 46(5):846-848. PMC: 7080116. DOI: 10.1007/s00134-020-05991-x. View

Kant S, Menez S, Hanouneh M, Fine D, Crews D, Brennan D . The COVID-19 nephrology compendium: AKI, CKD, ESKD and transplantation. BMC Nephrol. 2020; 21(1):449. PMC: 7590240. DOI: 10.1186/s12882-020-02112-0. View

10.

Mehta P, McAuley D, Brown M, Sanchez E, Tattersall R, Manson J . COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020; 395(10229):1033-1034. PMC: 7270045. DOI: 10.1016/S0140-6736(20)30628-0. View

11.

Braun F, Huber T, Puelles V . Proximal tubular dysfunction in patients with COVID-19: what have we learnt so far?. Kidney Int. 2020; 98(5):1092-1094. PMC: 7480737. DOI: 10.1016/j.kint.2020.09.002. View

12.

Khan S, Chen L, Yang C, Raghuram V, Khundmiri S, Knepper M . Does SARS-CoV-2 Infect the Kidney?. J Am Soc Nephrol. 2020; 31(12):2746-2748. PMC: 7790203. DOI: 10.1681/ASN.2020081229. View

13.

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y . Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 71(15):762-768. PMC: 7108125. DOI: 10.1093/cid/ciaa248. View

14.

Chan L, Chaudhary K, Saha A, Chauhan K, Vaid A, Zhao S . AKI in Hospitalized Patients with COVID-19. J Am Soc Nephrol. 2020; 32(1):151-160. PMC: 7894657. DOI: 10.1681/ASN.2020050615. View

15.

Batlle D, Soler M, Sparks M, Hiremath S, South A, Welling P . Acute Kidney Injury in COVID-19: Emerging Evidence of a Distinct Pathophysiology. J Am Soc Nephrol. 2020; 31(7):1380-1383. PMC: 7350999. DOI: 10.1681/ASN.2020040419. View

16.

Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L . Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020; 97(5):829-838. PMC: 7110296. DOI: 10.1016/j.kint.2020.03.005. View

17.

Naicker S, Yang C, Hwang S, Liu B, Chen J, Jha V . The Novel Coronavirus 2019 epidemic and kidneys. Kidney Int. 2020; 97(5):824-828. PMC: 7133222. DOI: 10.1016/j.kint.2020.03.001. View

18.

Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C . Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020; 18(1):206. PMC: 7237880. DOI: 10.1186/s12967-020-02374-0. View

19.

Driggin E, Madhavan M, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G . Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. J Am Coll Cardiol. 2020; 75(18):2352-2371. PMC: 7198856. DOI: 10.1016/j.jacc.2020.03.031. View

20.

Gabarre P, Dumas G, Dupont T, Darmon M, Azoulay E, Zafrani L . Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med. 2020; 46(7):1339-1348. PMC: 7290076. DOI: 10.1007/s00134-020-06153-9. View