Renal Involvement in Hospitalized COVID-19 Patients: Epidemiology, Risk Factors, and Correlation with Outcomes

Manouchehr Amini; Fatemeh Yaghoubi; Marjan Akhavan; Samira Abbasloo; Farnaz Tavakoli; Azarakhsh Baghdadi; Monir Sadat Hakemi

doi:10.18502/jimc.v5i2.10463

Manouchehr Amini Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Fatemeh Yaghoubi Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Marjan Akhavan Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Samira Abbasloo Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Farnaz Tavakoli Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Azarakhsh Baghdadi Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Monir Sadat Hakemi Nephrology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v5i2.10463

Keywords: Acute kidney injury, COVID-19, ICU admission, Mortality, ICU admission, Proteinuria, SARS-CoV-2

Abstract

Background: While respiratory tract symptoms are the most frequent reasons for hospital admission in COVID-19 patients, renal involvement is common and is associated with worse outcomes. The aim of this study was to determine the incidence, risk factors and outcome of Acute Kidney Injury (AKI) in hospitalized COVID-19 patients in a referral center.

Methods: In a retrospective review, patients hospitalized for COVID-

19 from February 2020 through April 2020 in a referral COVID center were studied. Demographic data, pre-existing comorbidities and drug history, along with laboratory data at presentation and during admission were recorded. AKI was diagnosed based on Kidney Disease Improving Global Outcomes (KDIGO) criteria. Data were analyzed to determine the incidence, risk factors and mortality of AKI.

Results: Finally, 200 patients were included, with a mean age of 60.5 years. Of these, 126 (63%) developed AKI and this number was 73.5% among the ICU-admitted patients. Patients who developed AKI were 4.29 times more likely to die. Pre-existing CKD, treatment with immunosuppressant, ICU admission, and the need for hemodialysis, were significantly associated with mortality. Among the eleven renal transplant recipients in this study, we found that a prior renal transplant was not associated with a higher rate of AKI but was significantly associated with increased mortality after correcting for age and gender.

Conclusion: Our findings showed a high incidence of AKI in patients admitted due to COVID-19, with a higher risk in ICU patients and it was a significant predictor of mortality. Further research is encouraged to understand the etiology of AKI, along with the long-term outcomes in the patients.