COVID-19 infection does not lead to acute kidney injury (AKI) or aggravate chronic kidney disease (CKD), according to a new Chinese study.

Of 116 COVID-19 patients hospitalized at Renmin Hospital of Wuhan University in Wuhan, China (median age 54 years; 58% male), 51% had mild pneumonia, 40% severe pneumonia, and 10% acute respiratory distress syndrome warranting an intensive care unit stay. Overall, 5 patients had dialysis-dependent CKD and 111 did not.

None of the non-CKD patients met diagnostic criteria for AKI during infection or treatment, Zuojiong Gong, MD, PhD, and colleagues from the hospital reported in the American Journal of Nephrology. Instead, 11% of these patients showed a mild increase in blood urea nitrogen or serum creatinine of less than 26 μmol/L within 48 hours and 7% showed trace or 1+ albuminuria that gradually resolved. According to the investigators, the temporary abnormal renal function was probably due to hypoxemia. SARS-CoV-2 RNA appeared in urine sediments of just 3 patients.

The 5 CKD patients displayed stable renal function during COVID-19 treatment while also receiving continuous renal replacement therapy (CRRT) thrice weekly. Only 1 patient had a positive test result for SARS-CoV-2 in urine.


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There were no predialysis patients in the cohort, which prevented evaluation of these patients at high risk for AKI.

“Nevertheless, the renal function of patients with COVID-19 needs to be monitored regularly, especially in patients with elevated plasma creatinine,” Dr Gong’s team stated. “In the event of signs of AKI, potential interventions, including CRRT, should be used to protect renal function as early as possible.”

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Reference

Wang L, Li X, Chen H, et al. Coronavirus disease 19 infection does not result in acute kidney injury: An analysis of 116 hospitalized patients from Wuhan, China [published online March 31, 2020]. Am J Nephrol. doi: 10.1159/000507471