Abstract
The development of acute kidney injury in COVID-19 patients is associated with a high risk of death. Published data demonstrate the possibility of severe kidney injury in patients suffering from COVID-19; however, these data are still controversial.
A total of 1,280 patients with a proven diagnosis of COVID-19 were included in our study. COVID-19 disease was confirmed by RT-PCR through a nasopharyngeal swab and typical images from a computed tomography scan in all patients. Demographic data, underlying comorbidities, and laboratory blood tests were assessed. We finally assessed the acute kidney injury (AKI) incidence and mortality defined by the survival status at discharge.
In 648 (50.6%) of the patients with COVID-19, proteinuria was evidenced. Haematuria was detected in 77 (6%) patients, and leukocyturia was detected in 282 (22%) hospitalized patients. AKI was determined in 371 (29%) patients, and 10 (2.7%) of them required dialysis. Independent AKI risk factors were age >65 years, augmentation of CRP, ferritin and increase in aPTT values as a result of consumption coagulopathy. A total of 162 (12.7%) of the 1,280 hospitalized patients and 111 (30%) of the 371 patients with AKI did not survive. The hazard ratio for mortality 3.96 [CI 95% 2.828 – 5.542] for patients with AKI vs. No-AKI.
AKI was determined in 29% patients, in 2.7% of them severe kidney injury required dialysis. Risk factors for AKI in COVID-19 patients are old age, the inflammatory response, the severity of lung involvement and DIC. The same factors and arterial hypertension were found to increase risk of mortality.
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