Gender and Ethnic Disparities of Acute Kidney Injury in COVID-19 Infected Patients: A Literature Review

Coronavirus disease 2019(COVID-19) has become a public health emergency of concern worldwide. COVID-19 is a new infectious disease arising from Coronavirus 2 (SARS-CoV-2). It has a strong transmission capacity and can cause severe and even fatal respiratory diseases. It can also affect other organs such as the heart, kidneys and digestive tract. Clinical evidence indicates that kidney injury is a common complication of COVID-19, and acute kidney injury (AKI) may even occur in severely ill patients. Data from China and the United States showed that male sex, Black race, the elderly, chronic kidney disease, diabetes, hypertension, cardiovascular disease, and higher body mass index are associated with COVID-19‐induced AKI. In this review, we found gender and ethnic differences in the occurrence and development of AKI in patients with COVID-19 through literature search and analysis. By summarizing the mechanism of gender and ethnic differences in AKI among patients with COVID-19, we found that male and Black race have more progress to COVID-19-induced AKI than their counterparts.

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ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

Wiadomości Lekarskie ◽

10.36740/wlek201908109 ◽

2019 ◽

Vol 72 (8) ◽

pp. 1466-1472

Author(s):

Grażyna Kobus ◽

Jolanta Małyszko ◽

Hanna Bachórzewska-Gajewska

Keyword(s):

Acute Kidney Injury ◽

Renal Failure ◽

Acute Renal Failure ◽

Elderly Patients ◽

Older Patients ◽

Age Groups ◽

Kidney Injury ◽

The Elderly ◽

Younger Patients ◽

Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

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The Current Management of Hepatorenal Syndrome‐Acute Kidney Injury in the United States and the Potential of Terlipressin

Liver Transplantation ◽

10.1002/lt.26072 ◽

2021 ◽

Author(s):

Steven L. Flamm ◽

Kimberly Brown ◽

Hani M. Wadei ◽

Robert S. Brown ◽

Marcelo Kugelmas ◽

...

Keyword(s):

United States ◽

Acute Kidney Injury ◽

Hepatorenal Syndrome ◽

Kidney Injury ◽

The United States ◽

Current Management

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Acute kidney injury in the elderly patients of Thai-surgical intensive care units (Thai-SICU) study

Australian Critical Care ◽

10.1016/j.aucc.2017.02.061 ◽

2017 ◽

Vol 30 (2) ◽

pp. 131

Author(s):

Konlawij Trongtrakul ◽

Sujaree Poopipatpab ◽

Ploynapas Limphunudom ◽

Chawika Pisitsak ◽

Kaweesak chittawatanarat ◽

...

Keyword(s):

Acute Kidney Injury ◽

Intensive Care ◽

Elderly Patients ◽

Intensive Care Units ◽

Kidney Injury ◽

The Elderly ◽

Surgical Intensive Care

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Acute Kidney Injury in the Elderly

Clinical Nephrogeriatrics ◽

10.1007/978-3-030-18711-8_8 ◽

2019 ◽

pp. 123-131

Author(s):

Myrto Giannopoulou ◽

Stefanos Roumeliotis ◽

Theodoros Eleftheriadis ◽

Vassilios Liakopoulos

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

The Elderly

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Rhabdomyolysis in a Hospitalized 16-Year-Old Boy: A Rarely Reported Underlying Cause

Case Reports in Pediatrics ◽

10.1155/2016/7873813 ◽

2016 ◽

Vol 2016 ◽

pp. 1-2 ◽

Cited By ~ 4

Author(s):

Rishika Singh ◽

Dilip R. Patel ◽

Sherry Pejka

Keyword(s):

United States ◽

Acute Kidney Injury ◽

Side Effect ◽

Kidney Injury ◽

The United States ◽

Multiple Factors ◽

Case Diagnosis ◽

Multiple Causes

Rhabdomyolysis can occur because of multiple causes and account for 7% of all cases of acute kidney injury annually in the United States. Identification of specific cause can be difficult in many cases where multiple factors could potentially cause rhabdomyolysis. We present a case of 16-year-old male who had seizures and was given levetiracetam that resulted in rhabdomyolysis. This side effect has been rarely reported previously and like in our case diagnosis may be delayed.

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Are Blacks at Higher Risk for Vancomycin-Related Acute Kidney Injury?

Journal of Pharmacy Practice ◽

10.1177/0897190018800093 ◽

2019 ◽

Vol 33 (5) ◽

pp. 592-597 ◽

Cited By ~ 1

Author(s):

Mamta Sharma ◽

Kaylin Braekevelt ◽

Pramodini Kale-Pradhan ◽

Susan Szpunar ◽

Riad Khatib

Keyword(s):

Acute Kidney Injury ◽

Clinical Characteristics ◽

Trough Level ◽

Kidney Injury ◽

Comorbid Conditions ◽

Black Race ◽

Source Of Infection ◽

Vancomycin Trough ◽

Nephrotoxic Drugs ◽

Trough Levels

Background: Black individuals have a higher lifetime risk of acute kidney injury (AKI) and chronic kidney disease than whites. Vancomycin has a potential for nephrotoxicity. The objective of this study was to determine whether the incidence of AKI among patients being treated with vancomycin differs by race. Methods: Retrospective study of adult (3 ≥18 years) inpatients who were on vancomycin for 348 hours between January 2012 and December 2014. Data on demographics, comorbid conditions, clinical characteristics, vancomycin dose, duration, and nephrotoxic drugs were collected. Patients with a creatinine clearance <30 mL/min or undergoing dialysis were excluded. Results: We identified 1130 patients during the study period; 48.1% (544) were black. The overall incidence of AKI was 8.2% (10.1% blacks, 6.5% whites; P = .03). Independent predictors of AKI included black race ( P = .011); higher Charlson score ( P = .006); higher body mass index (BMI; P = .002); higher vancomycin trough level ( P < .0001); and sepsis/systemic inflammatory response syndrome (<.0001), pneumonia ( P = .001) or gastrointestinal/genitourinary ( P = .025) as the source of infection. Conclusion: The incidence of vancomycin-related AKI was higher in blacks, independent of other risk factors. Based on our study, vancomycin trough levels and renal function need to be closely monitored in blacks.

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Acute Kidney Injury in Children Hospitalized With Diarrheal Illness in the United States

Hospital Pediatrics ◽

10.1542/hpeds.2019-0220 ◽

2019 ◽

Vol 9 (12) ◽

pp. 933-941 ◽

Cited By ~ 2

Author(s):

Christina Bradshaw ◽

Jialin Han ◽

Glenn M. Chertow ◽

Jin Long ◽

Scott M. Sutherland ◽

...

Keyword(s):

United States ◽

Acute Kidney Injury ◽

Kidney Injury ◽

The United States ◽

Diarrheal Illness

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Multimodal Analgesia and Decreased Opioid Use in Adult Trauma Patients

The American Surgeon ◽

10.1177/0003134820942177 ◽

2020 ◽

Vol 86 (8) ◽

pp. 950-954

Author(s):

Andrew L. Drahos ◽

Anthony M. Scott ◽

Tracy J. Johns ◽

Dennis W. Ashley

Keyword(s):

Acute Kidney Injury ◽

Management Strategies ◽

Kidney Injury ◽

Multimodal Analgesia ◽

The United States ◽

Control Group ◽

Trauma Patients ◽

Opioid Use ◽

Trauma Service ◽

The Impact

Background There is an opioid epidemic in the United States. With the increased concern of over-prescribing opioids, physicians are seeking alternative pain management strategies. The purpose of this study is to review the impact of instituting a multimodal analgesia (MMA) guideline on decreasing opioid use in trauma patients at a Level 1 trauma center. Methods In 2017, an MMA guideline was developed and included anti-inflammatories, muscle relaxants, neuropathic agents, and local analgesics in addition to opioids. Staff were educated and the guideline was implemented. A retrospective review of medications prescribed to patients admitted from 2016 through 2018 was performed. Patients admitted in 2016 served as the control group (before MMA). In 2018, all patients received multimodal pain therapy as standard practice, and served as the comparison group. Results A total of 10 340 patients were admitted to the trauma service from 2016 through 2018. There were 3013 and 3249 patients for review in 2016 and 2018, respectively. Total morphine milligram equivalents were 2 402 329 and 1 975 935 in 2016 and 2018, respectively, a 17.7% decrease ( P < .001). Concurrently, there was a statistically significant increase in the use of multimodal pain medications. A secondary endpoint was studied to evaluate for changes in acute kidney injury; there was not a statistically significant increase (0.56% versus 0.68%, P = .55). Discussion Implementation of an MMA guideline significantly reduced opioid use in trauma patients. The use of nonopioid MMA medications increased without an increased incidence of acute kidney injury.

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Acute kidney injury in the elderly

10.1093/med/9780199592548.003.0240_update_001 ◽

2018 ◽

Author(s):

Dinna N. Cruz ◽

Anna Clementi ◽

Mitchell H. Rosner

Keyword(s):

Elderly Patient ◽

Acute Kidney Injury ◽

Urinary Tract Obstruction ◽

Kidney Injury ◽

The Elderly ◽

Careful Analysis ◽

Volume Depletion ◽

Age Related ◽

Short And Long Term ◽

Aggressive Care

Acute kidney injury (AKI) is largely a disease of the elderly patient. As described in this chapter, age-related changes in the kidney as well as the accumulated co-morbid conditions and polypharmacy associated with ageing greatly increase the susceptibility to the development of AKI. The aetiologies of AKI in the elderly patient represent the same spectrum of prerenal, intrarenal, and postrenal causes as in other age categories. However, elderly patients tend to have a higher relative risk for developing AKI due to volume depletion and urinary tract obstruction. Diagnosis of AKI can be confounded by the use of serum creatinine which has limitations in the diagnosis of AKI.Poorer short- and long-term outcomes may influence decision-making on the provision of aggressive care such as offering renal replacement therapy. These complex decisions require a careful analysis of potential outcomes as well as coordinated discussions with family members to ensure that the most thoughtful and rational treatments are offered.

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