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. 2024 Sep-Oct;34(5):461-466.
doi: 10.25259/ijn_399_23. Epub 2024 May 11.

A Prospective Study of Incidence, Risk Factors, and Outcomes of Acute Kidney Injury in Coronavirus Disease 2019

Shyam Bihari Bansal  1 , Mayur Babras  2 , Abhyudaysingh Rana  1 , Amit Mahapatra  1 , Dinesh Kumar Yadav  1 , Sidharth Kumar Sethi  1
Affiliations

A Prospective Study of Incidence, Risk Factors, and Outcomes of Acute Kidney Injury in Coronavirus Disease 2019

Shyam Bihari Bansal et al. Indian J Nephrol. 2024 Sep-Oct.

Abstract

Background: Acute kidney injury (AKI) is common after coronavirus 2 infection (COVID-19), leading to higher morbidity and mortality. There is little prospective data from India regarding the incidence, risk factors, and outcome of AKI in COVID-19.

Materials and methods: This study was conducted prospectively in adult patients between September and December 2020 in a tertiary care hospital in the national capital region of Delhi. A total of 856 patients with COVID-19 infection were enrolled in the study. Survivors were followed for 3 months after discharge.

Results: Out of 856 patients, 207 (24%) developed AKI. AKI was significantly higher in those with severe disease as compared to mild-moderate disease (88% vs. 12%, P = 0.04). Out of all AKI, 3.4% had stage 1, 9.2% had stage 2, and the rest 87.4% had stage 3 AKI. 183/207 (88%) patients were on mechanical ventilators, 133 (64%) required inotropic support, and 137/207 (83.6%) patients required kidney replacement therapy. Out of 207 AKI patients, 74% (153) died as compared to 4% (27) in non-AKI group (P = 0.0001). After 3 months, chronic kidney disease (CKD) developed in 10/54 (18.5%) patients. On multivariable analysis, the presence of diabetes mellitus, severe COVID-19 disease, high levels of C reactive protein, lactate dehydrogenase, D-Dimer, and use of intravenous steroids, tocilizumab and remdesivir, were found to be significant predictors of AKI.

Conclusion: AKI is common after COVID-19 infection and it is a significant risk factor for mortality in COVID-19. Patients with diabetes and high levels of inflammatory markers have higher mortality. CKD may develop in many patients after discharge.

Keywords: Acute kidney injury; COVID-19; India; Kidney replacement therapy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Kaplan Meier’s survival analysis between acute kidney injury (AKI) and non-AKI (320 × 320 pixel).
See this image and copyright information in PMC

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