Critical Care and Shock

COVID-19 in hospitalized patients with and without acute kidney injury

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Introduction: Acute kidney injury (AKI) has emerged as a significant complication in coronavirus disease 2019 (COVID-19) patients, contributing to adverse clinical outcomes. This study aimed to investigate the association between AKI and COVID-19 infection, identifying risk factors and evaluating renal dysfunction severity according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.

Methods: A retrospective cohort analysis was conducted at a single-center hospital in Houston, Texas, involving 919 hospitalized COVID-19 patients from March 2020 to February 2022. Patient data, demographics, clinical profiles, severity scores, and outcomes were collected from electronic medical records.

Results: Of the 919 patients, 214 (23.28%) developed AKI, with older age, male sex, black race, obesity, hypertension, diabetes mellitus, congestive heart failure, chronic kidney disease (CKD), acute respiratory distress syndrome (ARDS), invasive ventilation, and use of diuretics and vasopressors being significant risk factors. AKI severity, categorized by KDIGO guidelines, showed a higher mortality rate in patients with more severe stages, emphasizing the importance of early recognition and intervention.

Conclusions: This study highlights the high incidence of AKI in COVID-19 patients and its association with adverse clinical outcomes, particularly in those with identified risk factors and severe disease. Comprehensive management strategies targeting identified risk factors and understanding the complex pathophysiological mechanisms contributing to AKI are essential in improving patient outcomes.

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