Hirsch (2020)
Acute kidney injury in patients hospitalized with COVID-19
https://doi.org/10.1016/j.kint.2020.05.006
http://dx.doi.org/10.1016/j.kint.2020.05.006
Comorbidities
Diabetes (Present vs. Not present)
COVID-19 (Acute Kidney Injury)
Odds ratio: 1.760 (1.490-2.070) Adjusted model

USA

Retrospective cohort study

Medical records

5449

Reviewed the health records for all patients hospitalized with Covid-19 between March 1, and April 5, 2020, at 13 academic and community hospitals in metropolitan New York. Of these, 5449 were used as the analysis cohort.

Overall, 1993 of 5449 patients (36.6%) developed AKI during their hospitalization. The peak stages of AKI were stage 1 in 46.5%, stage 2 in 22.4%, and stage 3 in 31.1%. Most cases developed early in the course, with 37.3% either arriving with AKI or developing it within 24 hours of admission. The number of patients requiring dialytic support at some point was 285 (overall 5.2% of all patients, representing 14.3% of those with AKI). The modality utilized was intermittent hemodialysis only in 154 patients (54% of all patients requiring RRT), continuous RRT only in 70 (24.6%) and requirement of both treatments at some point in 61 (21.4%). The median time of initiation of dialytic support from hospital admission was 2.0 (interquartile range [IQR]: -1.63, 141) hours. The median number of hours from AKI diagnosis to initiation of dialysis was 0.0 (IQR: 0.0, 79.6). The primary outcome was the development of AKI. Secondary outcomes included need for renal replacement therapy (RRT) and hospital disposition (i.e., discharge or death). The RRT modalities offered to patients with AKI in our health system were intermittent hemodialysis or continuous CRRT. All patients were followed up through April 12, 2020. Age (yr) 64.0 (52.0, 75.0) Male 3317 (60.9) Race Asian 466 (8.6) Black 1123 (20.6) White 2112 (38.8) Declined 32 (0.6) Other/multiracial 1494 (27.4) Other/unknown 222 (4.1)

Total

43 Day


COVID-19 (Acute Kidney Injury)

1993

Developing acute kidney injury (AKI) during the hospitalization


Comorbidities

Diabetes

diabetes mellitus

Not present

Present


Odds ratio

1.760 (1.490-2.070)

No

Yes

Yes

Age, male gender, race, treatment in a tertiary care hospital, diabetes, hypertension, cardiovascular disease, Obesity, cancer, mechanical ventilation, and Treatment like vasoactive medication and ACE-I or ARB use


none

Average

Yes