Acute kidney injury in patients hospitalized with COVID-19 from the ISARIC WHO CCP-UK Study: a prospective, multicentre cohort study.
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Authors
Drake, Thomas M
Docherty, Annemarie B
Oates, Georgia
Hardwick, Hayley E
Russell, Clark D
Merson, Laura
Dunning, Jake
Nguyen-Van-Tam, Jonathan S
Openshaw, Peter
Harrison, Ewen M
Baillie, J Kenneth
ISARIC4C Investigators
Publication Date
2022-01-25Journal Title
Nephrol Dial Transplant
ISSN
0931-0509
Publisher
Oxford University Press (OUP)
Volume
37
Issue
2
Pages
271-284
Type
Article
This Version
VoR
Physical Medium
Print
Metadata
Show full item recordCitation
Sullivan, M. K., Lees, J. S., Drake, T. M., Docherty, A. B., Oates, G., Hardwick, H. E., Russell, C. D., et al. (2022). Acute kidney injury in patients hospitalized with COVID-19 from the ISARIC WHO CCP-UK Study: a prospective, multicentre cohort study.. Nephrol Dial Transplant, 37 (2), 271-284. https://doi.org/10.1093/ndt/gfab303
Abstract
BACKGROUND: Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19). This study investigated adults hospitalized with COVID-19 and hypothesized that risk factors for AKI would include comorbidities and non-White race. METHODS: A prospective multicentre cohort study was performed using patients admitted to 254 UK hospitals with COVID-19 between 17 January 2020 and 5 December 2020. RESULTS: Of 85 687 patients, 2198 (2.6%) received acute kidney replacement therapy (KRT). Of 41 294 patients with biochemistry data, 13 000 (31.5%) had biochemical AKI: 8562 stage 1 (65.9%), 2609 stage 2 (20.1%) and 1829 stage 3 (14.1%). The main risk factors for KRT were chronic kidney disease (CKD) [adjusted odds ratio (aOR) 3.41: 95% confidence interval 3.06-3.81], male sex (aOR 2.43: 2.18-2.71) and Black race (aOR 2.17: 1.79-2.63). The main risk factors for biochemical AKI were admission respiratory rate >30 breaths per minute (aOR 1.68: 1.56-1.81), CKD (aOR 1.66: 1.57-1.76) and Black race (aOR 1.44: 1.28-1.61). There was a gradated rise in the risk of 28-day mortality by increasing severity of AKI: stage 1 aOR 1.58 (1.49-1.67), stage 2 aOR 2.41 (2.20-2.64), stage 3 aOR 3.50 (3.14-3.91) and KRT aOR 3.06 (2.75-3.39). AKI rates peaked in April 2020 and the subsequent fall in rates could not be explained by the use of dexamethasone or remdesivir. CONCLUSIONS: AKI is common in adults hospitalized with COVID-19 and it is associated with a heightened risk of mortality. Although the rates of AKI have fallen from the early months of the pandemic, high-risk patients should have their kidney function and fluid status monitored closely.
Keywords
COVID-19, SARS-CoV-2, acute kidney injury, dialysis, renal failure, Acute Kidney Injury, COVID-19, Cohort Studies, Hospital Mortality, Humans, Male, Prospective Studies, Retrospective Studies, Risk Factors, SARS-CoV-2, United Kingdom, World Health Organization
Identifiers
External DOI: https://doi.org/10.1093/ndt/gfab303
This record's URL: https://www.repository.cam.ac.uk/handle/1810/336591
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