TY - JOUR
T1 - Acute kidney injury in patients hospitalized with COVID-19
AU - Northwell COVID-19 Research Consortium
AU - Northwell Nephrology COVID-19 Research Consortium
AU - Hirsch, Jamie S.
AU - Ng, Jia H.
AU - Ross, Daniel W.
AU - Sharma, Purva
AU - Shah, Hitesh H.
AU - Barnett, Richard L.
AU - Hazzan, Azzour D.
AU - Fishbane, Steven
AU - Jhaveri, Kenar D.
AU - Abate, Mersema
AU - Andrade, Hugo Paz
AU - Bellucci, Alessandro
AU - Bhaskaran, Madhu C.
AU - Corona, Antonio G.
AU - Chang, Bessy Flores
AU - Finger, Mark
AU - Gitman, Michael
AU - Halinski, Candice
AU - Hasan, Shamir
AU - Hong, Susana
AU - Khanin, Yuriy
AU - Kuan, Aireen
AU - Madireddy, Varun
AU - Malieckal, Deepa
AU - Muzib, Abdulrahman
AU - Nair, Gayatri
AU - Nair, Vinay V.
AU - Parikh, Rushang
AU - Sakhiya, Vipulbhai
AU - Sachdeva, Mala
AU - Schwarz, Richard
AU - Singhal, Pravin C.
AU - Uppal, Nupur N.
AU - Wanchoo, Rimda
AU - Bessy Suyin Flores Chang, Suyin Flores Chang
AU - Ng, Jia Hwei
N1 - Publisher Copyright:
© 2020 International Society of Nephrology
PY - 2020/7
Y1 - 2020/7
N2 - The rate of acute kidney injury (AKI) associated with patients hospitalized with Covid-19, and associated outcomes are not well understood. This study describes the presentation, risk factors and outcomes of AKI in patients hospitalized with Covid-19. We 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. Patients younger than 18 years of age, with end stage kidney disease or with a kidney transplant were excluded. AKI was defined according to KDIGO criteria. Of 5,449 patients admitted with Covid-19, AKI developed in 1,993 (36.6%). The peak stages of AKI were stage 1 in 46.5%, stage 2 in 22.4% and stage 3 in 31.1%. Of these, 14.3% required renal replacement therapy (RRT). AKI was primarily seen in Covid-19 patients with respiratory failure, with 89.7% of patients on mechanical ventilation developing AKI compared to 21.7% of non-ventilated patients. 276/285 (96.8%) of patients requiring RRT were on ventilators. Of patients who required ventilation and developed AKI, 52.2% had the onset of AKI within 24 hours of intubation. Risk factors for AKI included older age, diabetes mellitus, cardiovascular disease, black race, hypertension and need for ventilation and vasopressor medications. Among patients with AKI, 694 died (35%), 519 (26%) were discharged and 780 (39%) were still hospitalized. AKI occurs frequently among patients with Covid-19 disease. It occurs early and in temporal association with respiratory failure and is associated with a poor prognosis.
AB - The rate of acute kidney injury (AKI) associated with patients hospitalized with Covid-19, and associated outcomes are not well understood. This study describes the presentation, risk factors and outcomes of AKI in patients hospitalized with Covid-19. We 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. Patients younger than 18 years of age, with end stage kidney disease or with a kidney transplant were excluded. AKI was defined according to KDIGO criteria. Of 5,449 patients admitted with Covid-19, AKI developed in 1,993 (36.6%). The peak stages of AKI were stage 1 in 46.5%, stage 2 in 22.4% and stage 3 in 31.1%. Of these, 14.3% required renal replacement therapy (RRT). AKI was primarily seen in Covid-19 patients with respiratory failure, with 89.7% of patients on mechanical ventilation developing AKI compared to 21.7% of non-ventilated patients. 276/285 (96.8%) of patients requiring RRT were on ventilators. Of patients who required ventilation and developed AKI, 52.2% had the onset of AKI within 24 hours of intubation. Risk factors for AKI included older age, diabetes mellitus, cardiovascular disease, black race, hypertension and need for ventilation and vasopressor medications. Among patients with AKI, 694 died (35%), 519 (26%) were discharged and 780 (39%) were still hospitalized. AKI occurs frequently among patients with Covid-19 disease. It occurs early and in temporal association with respiratory failure and is associated with a poor prognosis.
KW - AKI
KW - COVID-19
KW - continuous RRT
KW - dialysis
KW - renal failure
UR - http://www.scopus.com/inward/record.url?scp=85085323715&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85085323715&partnerID=8YFLogxK
U2 - 10.1016/j.kint.2020.05.006
DO - 10.1016/j.kint.2020.05.006
M3 - Article
C2 - 32416116
AN - SCOPUS:85085323715
SN - 0085-2538
VL - 98
SP - 209
EP - 218
JO - Kidney international
JF - Kidney international
IS - 1
ER -