Patients with acute kidney injury (AKI) during a COVID-19 hospitalization remain at high risk for death after discharge, especially when AKI does not resolve, according to a new study.
Among 1017 patients hospitalized with COVID-19 who survived until discharge, 298 patients (29.3%) experienced in-hospital AKI. Of these, 178 patients (59.7%) still had unresolved kidney injury at the time of discharge.
In univariate analysis, unresolved kidney injury and AKI stages 2 and 3 were significantly associated with 2.9-, 2.8-, and 7.3-fold increased risk for all-cause mortality over a median 9.6 months, compared with no AKI, Effat Razeghi, MD, of Tehran University of Medical Sciences in Iran and colleagues reported in Kidney and Blood Pressure Research. In multivariate analysis, AKI stage 3 and unresolved kidney injury remained significantly associated with a 4.6- and 2.1-fold increased risk for death, respectively.
“Given the results provided by this study, it seems vital to pay greater attention to patients with COVID-19-associated AKI, in particular patients with higher stages of AKI and patients with unresolved kidney dysfunction at the time of discharge, irrespective of the kidney state in the subsequent follow-ups,” Dr Razeghi’s team wrote.
Patients with vs without COVID-19-associated AKI were significantly older (59.9 vs 56.6 years) and more likely to be male (86.2% vs 50.2%). Those with hypertension, diabetes mellitus, dyslipidemia, coronary artery disease, congestive heart failure, cerebrovascular accident, and chronic kidney disease were more likely to develop AKI.
Hadadi A, Farrokhpour H, Rashedi S, et al. Long-term impact of the COVID-19 associated AKI: The relationship between kidney recovery and mortality in a 10-month follow-up cohort study. Kidney Blood Press Res 47(7):486-491. doi:10.1159/000524451