Patients hospitalized with influenza who develop  acute kidney injury (AKI)  experience worse morbidity and mortality than their counterparts without AKI, investigators reported at Kidney Week 2020 Reimagined, avirtual meeting sponsored by the American Society of Nephrology.

Among 120,730 influenza hospitalizations within the 2012 to 2014 National Inpatient Sample, 16,270 (13.5%) were complicated with AKI. After adjusting for potential confounders, patients with AKI had 3.8-, 8.7-, 9.5-, 3.0-, and 5.6-fold increased odds for mortality(P <.001), severe sepsis, septic shock, rhabdomyolysis, and intubation (P <.001), respectively, Nasha Elavia, MD, of the Wright Center for Graduate Medical Education in Scranton, Pennsylvania, and colleagues reported. Patients with AKI also had a significant 1.8 day longer length of stay and incurred $5054.40 higher health care costs (both P <.001).

With respect to comorbidities, patients with AKI were significantly more likely than those without AKI to have chronic kidney disease, hypertension, coronary artery disease, congestive heart failure, and diabetes and to have Charlson comorbidity index scores of 3 or higher (all P <.001). AKI was more likely to develop in men than women.

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“AKI in influenza patients is commonly seen specially when they develop a SIRS/sepsis clinical picture with hypotension and hence decreased renal perfusion,” Dr Elavia said. “Most treatment is aimed at symptomatic management even in the ICU setting with intravenous fluid resuscitation and vasopressors if needed. AKI may not be completely avoidable, but adequate fluid resuscitation and ensuring adequate renal perfusion in the first place can minimize renal damage.”


Elavia N, Li S, Yusuf I, Milekic B. AKI in hospitalized patients with influenza is associated with worse outcomes: a study of national inpatient sample from 2012 to 2014 in the United States. Presented at: Kidney Week 2020 Reimagined, October 19-25, 2020. Poster PO0059.