Burden and Risk Profile of Acute Kidney Injury in Severe COVID-19 Pneumonia Admissions: a Finding from Jimma University Medical Center, Ethiopia

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2024 Mar 20

PMID 38504176

Authors

Ebrahim Kelil Umer

Abel Tezera Abebe

Yabets Tesfaye Kebede

Nardos Tilahun Bekele

Affiliations

Soon will be listed here.

Abstract

Background: Acute kidney injury (AKI) is a serious complication of the Corona Virus Disease of 2019 (COVID-19). However, data on its magnitude and risk factors among hospitalized patients in Ethiopia is limited. This study aimed to determine the magnitude of AKI and associated factors among patients admitted for severe COVID-19 pneumonia.

Methods: An institution-based retrospective cross-sectional study was conducted among 224 patients admitted to Jimma University Medical Center in Ethiopia for severe COVID-19 pneumonia from May 2020 to December 2021. Systematic random sampling was used to select study participants. Medical records were reviewed to extract sociodemographic, clinical, laboratory, therapeutic, and comorbidity data. Bivariable and multivariable logistic regressions were performed to examine factors associated with AKI. The magnitude of the association between the explanatory variables and AKI was estimated using an adjusted odds ratio (AOR) with a 95% confidence interval (CI), and significance was declared at a p-value of 0.05.

Results: The magnitude of AKI was 42% (95% CI: 35.3-48.2%) in the study area. Mechanical ventilation, vasopressors, and antibiotics were required in 32.6, 3.7, and 97.7% of the patients, respectively. After adjusting for possible confounders, male sex (AOR 2.79, 95% CI: 1.3-6.5), fever (AOR 6.5, 95% CI: 2.7-15.6), hypoxemia (AOR 5.1, 95% CI: 1.4-18.9), comorbidities (AOR 2.8, 95% CI: 1.1-7.0), and severe anemia (AOR 10, 95% CI: 1.7-65.7) remained significantly associated with higher odds of AKI.

Conclusion: The burden of AKI among patients with severe COVID-19 pneumonia is high in our setting. Male sex, abnormal vital signs, chronic conditions, and anemia can identify individuals at increased risk and require close monitoring and prevention efforts.

References

Jayant K, Reccia I, Bachul P, Al-Salmay Y, Pyda J, Podda M . The Impact of COVID-19 on Kidney Transplant Recipients in Pre-Vaccination and Delta Strain Era: A Systematic Review and Meta-Analysis. J Clin Med. 2021; 10(19). PMC: 8509345. DOI: 10.3390/jcm10194533. View

Hidayat A, Gunawan V, Iragama F, Alfiansyah R, Hertanto D, Tjempakasari A . Risk Factors and Clinical Characteristics of Acute Kidney Injury in Patients with COVID-19: A Systematic Review and Meta-Analysis. Pathophysiology. 2023; 30(2):233-247. PMC: 10204466. DOI: 10.3390/pathophysiology30020020. View

Shu S, Wang Y, Zheng M, Liu Z, Cai J, Tang C . Hypoxia and Hypoxia-Inducible Factors in Kidney Injury and Repair. Cells. 2019; 8(3). PMC: 6468851. DOI: 10.3390/cells8030207. View

Lameire N, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum J . Acute kidney injury: an increasing global concern. Lancet. 2013; 382(9887):170-9. DOI: 10.1016/S0140-6736(13)60647-9. View

Khwaja A . KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012; 120(4):c179-84. DOI: 10.1159/000339789. View

Glowacka M, Lipka S, Mlynarska E, Franczyk B, Rysz J . Acute Kidney Injury in COVID-19. Int J Mol Sci. 2021; 22(15). PMC: 8347536. DOI: 10.3390/ijms22158081. View

Santana K, Santos A, Magalhaes F, Oliveira J, Pinheiro F, Santos E . Prevalence and factors associated with acute kidney injury in patients in intensive care units. Rev Bras Enferm. 2021; 74(2):e20200790. DOI: 10.1590/0034-7167-2020-0790. View

Mohammed Magboul S, Osman B, Elnour A . The incidence, risk factors, and outcomes of acute kidney injury in the intensive care unit in Sudan. Int J Clin Pharm. 2020; 42(6):1447-1455. PMC: 7502153. DOI: 10.1007/s11096-020-01147-5. View

Abebe A, Kumela K, Belay M, Kebede B, Wobie Y . Mortality and predictors of acute kidney injury in adults: a hospital-based prospective observational study. Sci Rep. 2021; 11(1):15672. PMC: 8329200. DOI: 10.1038/s41598-021-94946-3. View

10.

. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010; 33 Suppl 1:S62-9. PMC: 2797383. DOI: 10.2337/dc10-S062. View

11.

Feinstein A . THE PRE-THERAPEUTIC CLASSIFICATION OF CO-MORBIDITY IN CHRONIC DISEASE. J Chronic Dis. 2015; 23(7):455-68. DOI: 10.1016/0021-9681(70)90054-8. View

12.

Hirsch J, Ng J, Ross D, Sharma P, Shah H, Barnett R . Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. 2020; 98(1):209-218. PMC: 7229463. DOI: 10.1016/j.kint.2020.05.006. View

13.

Kaminska H, Szarpak L, Kosior D, Wieczorek W, Szarpak A, Al-Jeabory M . Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis. Acta Diabetol. 2021; 58(8):1101-1110. PMC: 8005367. DOI: 10.1007/s00592-021-01701-1. View

14.

Chen Y, Shao S, Hsu C, Wu I, Hung M, Chen Y . Incidence of acute kidney injury in COVID-19 infection: a systematic review and meta-analysis. Crit Care. 2020; 24(1):346. PMC: 7296284. DOI: 10.1186/s13054-020-03009-y. View

15.

Nangaku M, Eckardt K . Hypoxia and the HIF system in kidney disease. J Mol Med (Berl). 2007; 85(12):1325-30. DOI: 10.1007/s00109-007-0278-y. View

16.

Chen J, Kuo G, Lee T, Yang H, Wu H, Tu K . Incidence of Mortality, Acute Kidney Injury and Graft Loss in Adult Kidney Transplant Recipients with Coronavirus Disease 2019: Systematic Review and Meta-Analysis. J Clin Med. 2021; 10(21). PMC: 8584628. DOI: 10.3390/jcm10215162. View

17.

Alexander M, Mangalaparthi K, Madugundu A, Moyer A, Adam B, Mengel M . Acute Kidney Injury in Severe COVID-19 Has Similarities to Sepsis-Associated Kidney Injury: A Multi-Omics Study. Mayo Clin Proc. 2021; 96(10):2561-2575. PMC: 8279954. DOI: 10.1016/j.mayocp.2021.07.001. View

18.

Costa R, Soria T, Salles E, Gerecht A, Corvisier M, Menezes M . Acute kidney injury in patients with Covid-19 in a Brazilian ICU: incidence, predictors and in-hospital mortality. J Bras Nefrol. 2021; 43(3):349-358. PMC: 8428632. DOI: 10.1590/2175-8239-JBN-2020-0144. View

19.

Cai X, Wu G, Zhang J, Yang L . Risk Factors for Acute Kidney Injury in Adult Patients With COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2021; 8:719472. PMC: 8685316. DOI: 10.3389/fmed.2021.719472. View

20.

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