Sullivan, M. K. et al. (2022) Acute kidney injury in patients hospitalised with COVID-19 from the ISARIC WHO CCP-UK Study: a prospective, multicentre cohort study. Nephrology Dialysis Transplantation, 37(2), pp. 271-284. (doi: 10.1093/ndt/gfab303) (PMID:34661677) (PMCID:PMC8788218)
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Abstract
Background: Acute kidney injury (AKI) is common in COVID-19. This study investigated adults hospitalised with COVID-19 and hypothesised that risk factors for AKI would include co-morbidities and non-white race. Methods: A prospective multicentre cohort study was performed using patients admitted to 254 UK hospitals with COVID-19 between January 17th 2020 and December 5th 2020. Results: Of 85,687 patients, 2,198 (2.6%) received acute kidney replacement therapy (KRT). Of 41,294 patients with biochemistry data, 13,000 (31.5%) had biochemical AKI: 8,562 stage 1 (65.9%), 2,609 stage 2 (20.1%) and 1,829 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); 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 hospitalised 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.
Item Type: | Articles |
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Additional Information: | Janet T. Scott and Christopher Davis are members of the ISARIC4C Investigators. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Scott, Dr Janet and Mark, Professor Patrick and Sullivan, Dr Michael and Davis, Dr Chris and Lees, Jennifer and Ho, Dr Antonia |
Creator Roles: | Sullivan, M. K.Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Visualization, Writing – original draft, Writing – review and editing Lees, J. S.Conceptualization, Formal analysis, Investigation, Methodology, Visualization, Writing – original draft, Writing – review and editing Ho, A.Conceptualization, Formal analysis, Investigation, Methodology, Supervision, Visualization, Writing – original draft, Writing – review and editing Mark, P. B.Conceptualization, Investigation, Methodology, Supervision, Visualization, Writing – original draft, Writing – review and editing |
Authors: | Sullivan, M. K., Lees, J. S., Drake, T. M., Docherty, A. B., Oates, G., Hardwick, H. E., Russell, C. D., Merson, L., Dunning, J., Nguyen-Van-Tam, J. S., Openshaw, P., Harrison, E. M., Baillie, J. K., ISARIC4C Investigators, , Semple, M. G., Ho, A., Mark, P. B., Scott, J. T., and Davis, C. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Infection & Immunity College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research |
Journal Name: | Nephrology Dialysis Transplantation |
Publisher: | Oxford University Press |
ISSN: | 0931-0509 |
ISSN (Online): | 1460-2385 |
Published Online: | 18 October 2021 |
Copyright Holders: | Copyright © 2021 The Authors |
First Published: | First published in Nephrology Dialysis Transplantation 37(2): 271-284 |
Publisher Policy: | Reproduced under a Creative Commons License |
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