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Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology

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dc.contributor.authorARIKAN, İZZET HAKKI
dc.contributor.authorsArikan, Hakki; Ozturk, Savas; Tokgoz, Bulent; Dursun, Belda; Seyahi, Nurhan; Trabulus, Sinan; Islam, Mahmud; Ayar, Yavuz; Gorgulu, Numan; Karadag, Serhat; Gok, Mahmut; Akcali, Esra; Bora, Feyza; Aydin, Zeki; Altun, Eda; Ahbap, Elbis; Polat, Mehmet; Soypacaci, Zeki; Oguz, Ebru Gok; Koyuncu, Sumeyra; Colak, Hulya; Sahin, Idris; Dolarslan, Murside Esra; Helvaci, Ozant; Kurultak, Ilhan; Eren, Zehra; Dheir, Hamad; Ogutmen, Melike Betul; Taymez, Dilek Guven; Genek, Dilek Gibyeli; Ozkurt, Sultan; Bakir, Elif Ari; Yuksel, Enver; Sahutoglu, Tuncay; Oto, Ozgur Akin; Boz, Gulsah; Sengul, Erkan; Kara, Ekrem; Tuglular, Serhan
dc.date.accessioned2022-03-14T09:58:14Z
dc.date.available2022-03-14T09:58:14Z
dc.date.issued2021-08-10
dc.description.abstractBackground Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI. Methods In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients. Results The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality. Conclusions Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.
dc.identifier.doi10.1371/journal.pone.0256023
dc.identifier.issn1932-6203
dc.identifier.pubmed34375366
dc.identifier.urihttps://hdl.handle.net/11424/243791
dc.identifier.wosWOS:000683572000008
dc.language.isoeng
dc.publisherPUBLIC LIBRARY SCIENCE
dc.relation.ispartofPLOS ONE
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCLINICAL CHARACTERISTICS
dc.subjectDIALYSIS PATIENTS
dc.subjectDISEASE
dc.subjectTRANSPLANT
dc.subjectMORTALITY
dc.subjectWUHAN
dc.subjectINFECTION
dc.subjectCKD
dc.titleCharacteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology
dc.typearticle
dspace.entity.typePublication
local.avesis.id7b3dbad8-8e9f-467f-8fc1-0ee99ed44631
local.import.packageSS16
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.articlenumbere0256023
local.journal.numberofpages25
oaire.citation.issue8
oaire.citation.titlePLOS ONE
oaire.citation.volume16
relation.isAuthorOfPublication1fe3028b-011e-403a-ac08-1932d177a065
relation.isAuthorOfPublication.latestForDiscovery1fe3028b-011e-403a-ac08-1932d177a065

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