Acute kidney injury in patients hospitalized with COVID-19 in Wuhan, China:a single-center retrospective observational study

XIAO Guanhua; HU Hongbin; WU Feng; SHA Tong; ZENG Zhenhua; HUANG Qiaobing; LI Haijun; HAN Jiafa; SONG Wenhong; CHEN Zhongqing; CAI Shumin

doi:10.12122/j.issn.1673-4254.2021.02.01

Abstract：Objective To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19). Methods This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis. Results A total of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3％and that of stage 2 or 3 AKI was 4.9％. The patients with AKI had much higher mortality rate than those without AKI. Conclusions AKI is an important complication of COVID-19. An older age, a male gender, multiple pre-existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors of AKI. COVID-19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.