Sullivan, MK, Lees, JS, Drake, TM, Docherty, AB, Oates, G, Hardwick, HE, Russell, CD, Merson, L, Dunning, J, Nguyen-Van-Tam, JS et al (show 3 more authors)
(2022)
Acute kidney injury in patients hospitalized with COVID-19 from the ISARIC WHO CCP-UK Study: A prospective, multicentre cohort study
Nephrology Dialysis Transplantation, 37 (2).
pp. 271-284.
ISSN 0931-0509, 1460-2385
Abstract
Background: Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19). This study investigated adults hospitalized with COVID-19 and hypothesized that risk factors for AKI would include comorbidities and non-White race. Methods: A prospective multicentre cohort study was performed using patients admitted to 254 UK hospitals with COVID-19 between 17 January 2020 and 5 December 2020. Results: Of 85 687 patients, 2198 (2.6%) received acute kidney replacement therapy (KRT). Of 41 294 patients with biochemistry data, 13 000 (31.5%) had biochemical AKI: 8562 stage 1 (65.9%), 2609 stage 2 (20.1%) and 1829 stage 3 (14.1%). The main risk factors for KRT were chronic kidney disease (CKD) [adjusted odds ratio (aOR) 3.41: 95% confidence interval 3.06-3.81], male sex (aOR 2.43: 2.18-2.71) and Black race (aOR 2.17: 1.79-2.63). The main risk factors for biochemical AKI were admission respiratory rate >30 breaths per minute (aOR 1.68: 1.56-1.81), CKD (aOR 1.66: 1.57-1.76) and Black race (aOR 1.44: 1.28-1.61). There was a gradated rise in the risk of 28-day mortality by increasing severity of AKI: stage 1 aOR 1.58 (1.49-1.67), stage 2 aOR 2.41 (2.20-2.64), stage 3 aOR 3.50 (3.14-3.91) and KRT aOR 3.06 (2.75-3.39). AKI rates peaked in April 2020 and the subsequent fall in rates could not be explained by the use of dexamethasone or remdesivir. Conclusions: AKI is common in adults hospitalized with COVID-19 and it is associated with a heightened risk of mortality. Although the rates of AKI have fallen from the early months of the pandemic, high-risk patients should have their kidney function and fluid status monitored closely.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | acute kidney injury, COVID-19, dialysis, renal failure, SARS-CoV-2 |
| Divisions: | Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences Faculty of Health & Life Sciences > Inst. Systems, Molec & Integrative Biology > Inst. Systems, Molec & Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 11 Nov 2021 08:08 |
| Last Modified: | 21 Jan 2026 21:00 |
| DOI: | 10.1093/ndt/gfab303 |
| Open Access URL: | http://doi.org/10.1093/ndt/gfab303 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3143010 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
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