Acute Kidney Injury in COVID-19 Pneumonia: A Single-Center Experience in Bahrain

• Published in: Curēus (Palo Alto, CA) Vol. 12; no. 8; p. e9693
• Main Authors: Taher, Abdulraqeeb, Alalwan, Adel A, Naser, Naser, Alsegai, Ola, Alaradi, Ali
• Format: Journal Article
• Language: English
• Published: Palo Alto Cureus Inc 12-08-2020; Cureus
• Subjects: Age; Coronaviruses; COVID-19; Creatinine; Dehydrogenases; Diabetes; Electrolytes; Fever; Hemodialysis; Hemoglobin; Hospitalization; Hospitals; Hypertension; Infectious Disease; Intensive care; Kidney diseases; Laboratories; Lymphocytes; Monoclonal antibodies; Nephrology; Patients; Pneumonia; Pulmonology; Renal replacement therapy; Respiratory failure; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Standard deviation; Ventilators; United States > US; Bahrain; China
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.9693

BackgroundKidney disease accompanying coronavirus disease 2019 (COVID-19) is not well understood, and information about the presentation of acute kidney injury (AKI), its risk factors, and outcomes is scarce, particularly in Bahrain and the Gulf region. In this study, we aimed to determine the rate of AKI among patients hospitalized with COVID-19 pneumonia at a tertiary hospital in Bahrain and to describe the various aspects of AKI in these patients, including its relationship with respiratory failure and in-hospital mortality.MethodsThis retrospective observational cohort study of patients admitted with COVID-19 pneumonia from April 1 to May 31, 2020, excluded those aged less than 18 years, those with end-stage renal disease, and those with renal transplants. Clinical and laboratory patient data were collected. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to define AKI.ResultsThe mean age across the 73 included patients was approximately 54 years; about 60% were men, and nearly 58% were Bahraini nationals. Of the patients, 39.7% (29) developed AKI during hospitalization, out of which 11.0% reached stage 1, 15.1% reached stage 2, and 13.7% reached stage 3. Of all patients, seven (9.6%) required hemodialysis. Chronic kidney disease conferred an increased risk for AKI (P = 0.003) as did critical COVID-19 status (P < 0.001) and the necessity for mechanical ventilation or intensive care admission (P < 0.001 for both). Additionally, AKI was significantly associated with a lower PaO2/FiO2 (partial pressure of arterial oxygen/percentage of inspired oxygen) ratio (P < 0.001) and a greater number of medications for COVID-19 pneumonia (P = 0.003). Finally, in-hospital death tolls were remarkably higher in patients with AKI (P < 0.001). No association was found between AKI and each of the following therapies: angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, tocilizumab, and convalescent plasma.ConclusionsThe rate of AKI in patients hospitalized with COVID-19 pneumonia at our institution is relatively high and is strongly associated with disease severity, respiratory failure, and in-hospital mortality. Awareness of kidney disease in COVID-19 patients is crucial and of vital importance.