scholarly journals Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury

2020 ◽  
Vol 9 (6) ◽  
pp. 1718 ◽  
Author(s):  
Jeong-Hoon Lim ◽  
Sun-Hee Park ◽  
Yena Jeon ◽  
Jang-Hee Cho ◽  
Hee-Yeon Jung ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
Organ Damage ◽  
Acute Kidney Injury Network ◽  
Medical Data ◽  
Independent Risk Factors ◽  
Stage 1 ◽  
The Relationship ◽  
Low Serum

The outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severity. Medical data of hospitalized COVID-19 patients in two university-based hospitals during an outbreak in Daegu, South Korea, were retrospectively analyzed. AKI and its severity were defined according to the Acute Kidney Injury Network. Of the 164 hospitalized patients with COVID-19, 30 patients (18.3%) had AKI; 14, 4, and 12 patients had stage 1, 2, and 3, respectively. The median age was significantly higher in AKI patients than in non-AKI patients (75.5 vs. 67.0 years, p = 0.005). There were 17 deaths (56.7%) among AKI patients; 4 (28.6%), 1 (25.0%), and 12 (100.0%), respectively. In-hospital mortality was higher in AKI patients than in non-AKI patients (56.7% vs. 20.8%, p < 0.001). After adjusting for potential confounding factors, stage 3 AKI was associated with higher mortality than either non-AKI or stage 1 AKI (hazard ratio (HR) = 3.62 (95% confidence interval (CI) = 1.75–7.48), p = 0.001; HR = 15.65 (95% CI = 2.43–100.64), p = 0.004). Among the AKI patients, acute respiratory distress syndrome and low serum albumin on admission were considered independent risk factors for stage 3 AKI (both p < 0.05). Five patients with stage 3 AKI underwent dialysis and eventually died. In conclusion, COVID-19 patients with severe AKI had fatal outcomes.

Elevated Levels of Urinary Biomarkers TIMP-2 and IGFBP-7 Predict Acute Kidney Injury in Neonates after Congenital Heart Surgery

2021 ◽  
Author(s):  
Michelle Ramírez ◽  
Sujata Chakravarti ◽  
Jaclyn McKinstry ◽  
Yasir Al-qaqaa ◽  
Raj Sahulee ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Congenital Heart Surgery ◽  
Adverse Outcomes ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Stress Injury ◽  
Stage 1

Abstract Objectives: This article investigated the utility of urine biomarkers tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGFBP-7) in identifying acute kidney injury (AKI) in neonates after congenital heart surgery (CHS). TIMP-2 and IGFBP-7 are cell cycle arrest proteins detected in urine during periods of kidney stress/injury. Methods: We conducted a single-center, prospective study between September 2017 and May 2019 with neonates undergoing CHS requiring cardiopulmonary bypass (CPB). Urine samples were analyzed using NephroCheck prior to surgery and 6, 12, 24, and 96 hours post-CPB. All patients were evaluated using the Acute Kidney Injury Network (AKIN) criteria. Wilcoxon rank sum tests were used to compare the medians of the [TIMP-2*IGFBP-7] values in the AKIN negative and positive groups at each time point. Receiver operating characteristic curves were used to measure how well the [TIMP-2*IGFBP-7] values predict AKIN status. Results: Thirty-six patients were included. No patients met the AKIN criteria for AKI preoperatively. Postoperatively, 19 patients (53%) met the AKIN criteria for AKI diagnosis: 13 (36%) stage 1, 5 (14%) stage 2, and 1 (3%) stage 3. None required renal replacement therapy. At the 24-hour time points, patients who met the AKIN criteria for AKI had a statistically significantly higher [TIMP-2*IGFBP7] values than the patients without AKI (1.1 vs. 0.27 [ng/mL]2/1,000) at 24 hours (adj-p = 0.0019). Conclusion: AKI is a serious complication associated with adverse outcomes in patients undergoing cardiac surgery. [TIMP-2*IGFBP-7] urinary level 24 hours after CPB is a good predictor of AKI in this population.

scholarly journals Acute kidney injury in hospitalized patients due to COVID-19

2021 ◽  
Author(s):  
Pehuén Fernández ◽  
Emanuel José Saad ◽  
Augusto Douthat ◽  
Federico Ariel Marucco ◽  
María Celeste Heredia ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Cohort ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
Positive Association ◽  
Hospitalized Patients ◽  
Incidence Risk ◽  
History Of ◽  
Stage 1 ◽  
Bacterial Superinfection

The incidence of acute kidney injury (AKI) in hospitalized patients with coronavirus disease 2019 (COVID-19) is variable, being associated with worse outcomes. The objectives of the study were to evaluate the incidence, risk factors and impact of AKI in subjects hospitalized for COVID-19 in two third- level hospitals in Córdoba, Argentina. A retrospective cohort study was conducted. 448 adults who were consecutively hospitalized for COVID-19 between March and the end of October 2020 at Hospital Privado Universitario de Córdoba and Hospital Raúl Angel Ferreyra were included. The incidence of AKI was 19% (n=85). 50.6% presented AKI stage 1 (n=43), 20% stage 2 (n=17) and 29.4% stage 3 (n=25, of which 18 required renal replacement therapy). In the multivariate analysis, the variables that were independently associated with AKI were: age (adjusted Odd ratio -aOR- =1.30, 95%CI=1.04-1.63, p=0.022), history of chronic kidney disease (aOR=9.92, 95%CI=4.52-21.77, p<0.001), blood neutrophil count at admission (aOR=1.09, 95%CI=1.01-1.18, p=0.037) and requirement for mechanical ventilation (MV) (aOR=6.69, 95%CI=2.24-19.9, p=0.001). AKI was associated with longer hospitalization, greater admission and length of stay in the intensive care unit, a positive association with bacterial superinfection, sepsis, respiratory distress syndrome, MV requirement and mortality (mortality with AKI=47.1% vs without AKI=12.4%, p<0.001). AKI was independently associated with higher mortality (aOR=3.32, 95%CI=1.6-6.9, p=0.001). In conclusion, the incidence of AKI in adults hospitalized for COVID-19 was 19% and had a clear impact on morbidity and mortality. Local predisposing factors for AKI were identified.

scholarly journals Effect of Hydroxyethyl Starch on Postoperative Kidney Function in Patients Having Noncardiac Surgery

2014 ◽  
Vol 121 (4) ◽  
pp. 730-739 ◽  
Author(s):  
Babak Kateby Kashy ◽  
Attila Podolyak ◽  
Natalya Makarova ◽  
Jarrod E. Dalton ◽  
Daniel I. Sessler ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Function ◽  
Hydroxyethyl Starch ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Noncardiac Surgery ◽  
Baseline Risk ◽  
Primary Analysis ◽  
Primary Hypothesis ◽  
The Relationship

Abstract Background: Whether intraoperative use of hydroxyethyl starch impairs kidney function remains unknown. The authors thus tested the primary hypothesis that Hextend promotes renal injury in surgical patients. Secondarily, the authors evaluated the dose–outcome relationship, in-hospital and 90-day mortality, and whether the relationship between colloid use and acute kidney injury (AKI) depends on baseline risk for AKI. Methods: The authors evaluated the data of 44,176 adults without preexisting kidney failure who had inpatient noncardiac surgery from 2005 to 2012. Patients given a combination of colloid and crystalloid were propensity matched on morphometric, and baseline characteristics to patients given only crystalloid. The primary analysis was a proportional odds logistic regression with AKI as an ordinal outcome based on the Acute Kidney Injury Network classification. Results: The authors matched 14,680 patients receiving colloids with 14,680 patients receiving noncolloids for a total of 29,360 patients. After controlling for potential confounding variables, the odds of developing a more serious level of AKI with Hextend was 21% (6 to 38%) greater than with crystalloid only (P = 0.001). AKI risk increased as a function of colloid volume (P &lt; 0.001). In contrast, the relationship between colloid use and AKI did not differ on baseline AKI risk (P = 0.84). There was no association between colloid use and risk of in-hospital (P = 0.81) or 90-day (P = 0.02) mortality. Conclusion: Dose-dependent renal toxicity associated with Hextend in patients having noncardiac surgery is consistent with randomized trials in critical care patients.

scholarly journals Clinical features and risk factors of acute kidney injury in children with acute paraquat intoxication

2019 ◽  
Vol 47 (9) ◽  
pp. 4194-4203
Author(s):  
Yue Song ◽  
Chaofeng Li ◽  
Fenglan Luo ◽  
Yuhong Tao
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Blood Glucose ◽  
Kidney Injury ◽  
Elevated Blood ◽  
Glucose Levels ◽  
Oral Ulcers ◽  
Blood Glucose Levels ◽  
Independent Risk Factors ◽  
Stage 1

Objective This study aimed to investigate the clinical features and risk factors of acute kidney injury (AKI) in children with acute paraquat intoxication. Methods A retrospective study of 110 hospitalized children with acute paraquat intoxication in West China Second University Hospital, Sichuan University was conducted from January 2010 to May 2017. The Kaplan–Meier method was used to compare the survival rates of children with different AKI stages. Multivariate logistic regression was applied to analyse the risk factors for paraquat-induced AKI. Results AKI occurred in 42 of 110 (38.2%) children. We observed AKI stage 1 in two (4.8%) children, AKI stage 2 in 11 (26.2%), and AKI stage 3 in 29 (69.0%). The survival rate of children in AKI stage 3 (34.5%) was significantly lower than that in children in AKI stage 2 (63.6%) and AKI stage 1 (100%). Multivariate analysis showed that oral ulcers and elevated blood glucose levels were significant independent risk factors for paraquat-induced AKI in children (odds ratio = 4.223 and 5.545, respectively). Conclusions The incidence and mortality rates of paraquat-induced AKI in children are high. Oral ulcers and elevated blood glucose levels are independent risk factors affecting the occurrence of paraquat-induced AKI in children.

scholarly journals Severe acute kidney injury in COVID-19 patients is associated with in-hospital mortality

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243528
Author(s):  
Jin Hyuk Paek ◽  
Yaerim Kim ◽  
Woo Yeong Park ◽  
Kyubok Jin ◽  
Miri Hyun ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Multivariable Analysis ◽  
Kidney Injury ◽  
Hospital Death ◽  
Kaplan Meier ◽  
Kdigo Guidelines ◽  
Independent Risk Factors ◽  
Elevated Creatinine ◽  
Stage 1

Although the lungs are major targets for COVID-19 invasion, other organs—such as the kidneys—are also affected. However, the renal complications of COVID-19 are not yet well explored. This study aimed to identify the incidence of acute kidney injury (AKI) in patients with COVID-19 and to evaluate its impact on patient outcomes. This retrospective study included 704 patients with COVID-19 who were hospitalized at two hospitals in Daegu, Korea from February 19 to March 31, 2020. AKI was defined according to the serum creatinine criteria in the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The final date of follow-up was May 1, 2020. Of the 704 patients, 28 (4.0%) developed AKI. Of the 28 patients with AKI, 15 (53.6%) were found to have AKI stage 1, 3 (10.7%) had AKI stage 2, and 10 (35.7%) had AKI stage 3. Among these patients, 12 (42.9%) recovered from AKI. In the patients with AKI, the rates of admission to intensive care unit (ICU), administration of mechanical ventilator (MV), and in-hospital mortality were significantly higher than in patients without AKI. Multivariable analysis revealed that old age (Hazard ratio [HR] = 4.668, 95% confidence interval [CI] = 1.250–17.430, p = 0.022), high neutrophil-to-lymphocyte ratio (HR = 1.167, 95% CI = 1.078–1.264, p < 0.001), elevated creatinine kinase (HR = 1.002, 95% CI = 1.001–1.004, p = 0.007), and severe AKI (HR = 12.199, 95% CI = 4.235–35.141, p < 0.001) were independent risk factors for in-hospital mortality. The Kaplan-Meier curves showed that the cumulative survival rate was lowest in the AKI stage 3 group (p < 0.001). In conclusion, the incidence of AKI in patients with COVID-19 was 4.0%. Severe AKI was associated with in-hospital death.

scholarly journals Association between ABO blood groups and clinical outcome of coronavirus disease 2019: Evidence from two cohorts

2020 ◽  
Author(s):  
Xianfei Zeng ◽  
Hongyan Fan ◽  
Dongxue Lu ◽  
Fang Huang ◽  
Xi Meng ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Large Scale ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
Blood Type ◽  
Abo Blood Groups ◽  
Type Distribution ◽  
The Third ◽  
Medical Centers ◽  
The Relationship

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the third most common coronavirus that causes large-scale infections worldwide. The correlations between pathogen susceptibility and blood type distribution have attracted attention decades ago. The current retrospective study aimed to examine the correlation between blood type distribution and SARS-CoV-2 infection, progression, and prognosis in patients with coronavirus disease 2019 (COVID-19). With 265 patients from multiple medical centers and two established cohorts, we found that the blood type A population was more sensitive to SARS-CoV-2. Moreover, the blood type distribution was not relevant to acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and mortality in COVID-19 patients. These findings are indicative of coping with the great threat since it probed the relationship between blood types and ARDS, AKI, and mortality, in addition to susceptibility in COVID-19 patients.

Acute Kidney Injury in Neonates with Perinatal Asphyxia Receiving Therapeutic Hypothermia

2020 ◽  
Author(s):  
Ozlem Bozkurt ◽  
Ebru Yucesoy
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Therapeutic Hypothermia ◽  
Lactate Level ◽  
Perinatal Asphyxia ◽  
Characteristic Curve ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Bleeding Tendency ◽  
Independent Risk Factors

Abstract Objective To assess the incidence and severity of acute kidney injury (AKI) and evaluate risk factors that predict AKI in asphyxiated infants receiving therapeutic hypothermia. Study Design Infants ≥36 weeks' gestation diagnosed with moderate-to-severe perinatal asphyxia and received therapeutic hypothermia were reviewed retrospectively (n = 166). Modified Acute Kidney Injury Network criteria were used to diagnose AKI. The results of infants with AKI were compared with the infants who did not develop AKI. Results AKI developed in 49 (29.5%) infants, of whom 22 had stage I, 13 had stage II, and 14 had stage III AKI. The overall mortality rate was 15.7% and was significantly higher in infants with AKI when compared with infants without AKI (41 vs. 5%; p < 0.001). Asystole at birth (p = 0.044), placental abruption (p = 0.041), outborn status (p = 0.041), need for vasopressor support (p = 0.031), increased bleeding tendency (p = 0.031), initial lactate level (p = 0.015), and 12-hour lactate level (p = 0.029) were independent risk factors for the development of AKI. Receiver operating characteristic curve analysis demonstrated a good predictive value for initial lactate level (>15 mmol/L), with 69% sensitivity (95% CI: 55–82) and 82% specificity (95% CI: 74–89), and for 12-hour lactate level (>6 mmol/L), with 83.7% sensitivity (95% CI: 70–93) and 73.5% specificity (95% CI: 64.5–81), to predict AKI. Conclusion AKI is still a common complication of perinatal asphyxia despite treatment with therapeutic hypothermia. Identification of risk factors associated with the development of AKI in asphyxiated infants would be potentially beneficial to reduce morbidity and mortality. Besides perinatal risk factors, initial and 12-hour lactate concentrations can be used for the early prediction of AKI.

scholarly journals Multiple Organ Dysfunction Reduces In-Hospital Survival in COVID-19 Patients

2020 ◽  
Vol 5 (09) ◽  
pp. 389-394
Author(s):  
Najiba Abdulrazzaq ◽  
Kashif Bin Naeem ◽  
Abdalla Alhajiri ◽  
Ayman Chkhis ◽  
Vinod Choondal ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Organ Dysfunction ◽  
Distress Syndrome ◽  
Cardiac Injury ◽  
Kidney Injury ◽  
Organ Damage ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Hospital Survival ◽  
Multiple Organs

Background: Although primarily a respiratory illness, COVID-19 involves multiple organs when the disease is severe or critical. Hence, we conducted this study to evaluate the incidence of multiple organ dysfunction in COVID-19 patients and its implications on survival. Methods: A retrospective analysis of laboratory-confirmed COVID-19 patients presenting to our center in Dubai, UAE between April 2020 and July 2020. Data was collected from the electronic medical records and analyzed to evaluate multiple organ damage observed during hospital admission. Findings: Five-hundred patients were studied. Overall mean age was 49.5 years (range 13-94), 76% males, 33% diabetics, 31% hypertensives. 97/500 (19.4%) had evidence of single organ damage; 37/500 (7.4%) had two organ damage; and 105/500 (21%) had more than two organ damage. Acute respiratory distress syndrome was the most prevalent organ damage,153/500 (30.6%); followed by acute cardiac injury, 120/500 (24%); acute kidney injury 107/500 (21.4%); acute liver injury 96/500 (19.2%); septic shock 93/500 (18.6%); disseminated intravascular coagulation 27/500 (5.4%), and heart failure 17/500 (3.4%). We found that in-hospital survival reduced as the number of organs involved increased; only 20% patients survived who had more than 2 organ damage. Also, the chances of survival reduced considerably once other organs were involved in addition to the acute respiratory distress syndrome (91.6% survival in ARDS alone vs. 28.6% survival in ARDS with acute kidney injury vs. 10.4% survival in ARDS with shock/acute cardiac injury/acute kidney injury). Conclusion: Multiple organ dysfunction is common in COVID-19 as 21% had evidence of more than two organ damage in our study. The survival in COVID-19 reduces significantly once multiple organs are involved. Early monitoring and recognition of multiple organ dysfunction is necessary to prevent adverse outcomes and improve survival.

scholarly journals Acute Kidney Injury in COVID-19: clinical outcomes and risk factors

2020 ◽  
Author(s):  
Kui Jin ◽  
Tuxiu Xie ◽  
Sam Seery ◽  
Lu Ye ◽  
Jie Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Fibrinogen Concentration ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
Stage 1 ◽  
Early Detection And Prevention

Abstract Background:Understanding of the incidence and effects of acute kidney injury (AKI) in patients diagnosed with COVID-19 is limited. The purpose of this study was to examine risk factors and related outcomes associated with AKI among patients diagnosed with COVID-19. Method: This is a retrospective cohort study of patients diagnosed with COVID-19 associated-pneumonia admitted to a tertiary hospital in Wuhan between January to February 2020. AKI was defined and staged according to the Kidney Disease: Improving Global Outcome (KDIGO) classification criteria. Cox’s multivariate regression and logistic regression modelling were used to assess the effects of AKI on hospital mortality and risk factors associated with occurrence of AKI. Primary outcomes were risk-adjusted in-hospital mortality.Results:342 patients were finally enrolled in this study. AKI occurred in 13.4% (n = 46), among them 7.0% (n = 24) developed stage 1AKI, and 6.4% (n = 22) developed stage 2 - 3 AKI. Overall 26.9% (n = 92) died during hospitalization. Among them 19.3% (57/296) of the non-AKI patients died, 62.5%(15/24) of stage 1 AKI patients, and 90.9% (20/22) of stage 2 - 3 AKI patients died. AKI was strongly associated with mortality (HR 2.52; 95% CI, 1.59-3.96; p＜0.001). Further analysis shows that progression to AKI stage 2 - 3 doubles the hazard ratio for death. Age, leukocytes number, fibrinogen concentration, C-reative protein level, and severity of pneumonia at admission were independent risk factors associated with the development of AKI. Conclusion:Acute kidney injury is common among hospitalized COVID-19 patients and strongly associated with increased mortality, early detection and prevention of the progression of AKI may be critical to reduce mortality of these patients.

Sign in / Sign up

Export Citation Format

Share Document