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Observational Study
. 2021 Feb 25;41(2):157-163.
doi: 10.12122/j.issn.1673-4254.2021.02.01.

[Acute kidney injury in patients hospitalized with COVID-19 in Wuhan, China: a single-center retrospective observational study]

[Article in Chinese]
Guanhua Xiao  1 , Hongbin Hu  2 , Feng Wu  2 , Tong Sha  2 , Zhenhua Zeng  2 , Qiaobing Huang  3 , Haijun Li  4 , Jiafa Han  4 , Wenhong Song  4 , Zhongqing Chen  2 , Shumin Cai  2
Affiliations
Observational Study

[Acute kidney injury in patients hospitalized with COVID-19 in Wuhan, China: a single-center retrospective observational study]

[Article in Chinese]
Guanhua Xiao et al. Nan Fang Yi Ke Da Xue Xue Bao. .

Abstract

Objective: To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19).

Methods: This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis.

Results: Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI.

Conclusions: AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.

Keywords: acute kidney injury; coronavirus disease 2019; kidney function.

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Figures

<bold>A</bold>: Bilateral ground glass opacities are visible in the lungs on day 6 after symptom onset. <bold>B</bold>: Diffuse bilateral areas of ground-glass opacities and consolidation of the peripheries of both lungs on day 11 after symptom onset. <bold>C</bold>: Increased diffuse bilateral areas of ground glass opacities and consolidation on day 18 after symptom onset. <bold>D</bold>: Gradual resolution of consolidation and partially reticular pulmonary fibrosis on day 31 after symptom onset.
1
Transverse chest computed tomography (CT) images of the lungs of a 47-year-old man with COVID-19.
See this image and copyright information in PMC

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