High mortality and residual kidney damage with Coronavirus disease-19-associated acute kidney injury in northern India

• Published in: Clinical and experimental nephrology Vol. 26; no. 11; pp. 1067 - 1077
• Main Authors: Sharma, Harshita, Behera, Manas R., Bhadauria, Dharmendra Singh, Khushwaha, Ravi S., Yachha, Monika, Patel, Manas Ranjan, Kaul, Anupama, Prasad, Narayan
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01-11-2022; Springer Nature B.V
• Subjects: Coronaviruses; COVID-19; Creatinine; Hematuria; Kidneys; Medicine; Medicine & Public Health; Morbidity; Mortality; Nephrology; Original; Original Article; Proteinuria; Renal function; Urology; Residual kidney damage; Coronavirus disease-19; Acute kidney injury; Outcomes
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-022-02247-4

Background
Acute kidney injury (AKI) is associated with morbidity and mortality in COVID-19 patients. The incidence of AKI and its outcomes vary in different parts of the world. We aimed to analyze the AKI incidence, predictors of AKI, mortality, and renal function outcomes on follow-up in hospitalized patients with COVID-19.
Materials and methods
The study was designed as a retrospective, observational study of electronically captured data on the hospital information system of laboratory-confirmed COVID-19 patients, with and without AKI, between March 2020 to June 2021. The predictor of AKI and mortality and residual damage in recovered AKI patients were analyzed.
Results
Of the 3395 patients, 3010 COVID-19 patients were eligible. AKI occurred in 951 (31.5%); with stages 1, 2, and 3 in 605 (63.7%), 138 (14.5%), and 208 (21.8%) patients, respectively. AKI severity increased with COVID-19 severity. Of 951 AKI patients, 403 died, and 548 were discharged. AKI group had higher mortality (42.3%) than the non-AKI (6.6%). At discharge, complete recovery was noticed in 370(67.5%), while 178 (32.5%) had residual damage. At three months of follow-up, 108 (69.6%) of 155 patients showed complete recovery. Residual damage was observed in 47 (30.3%). In 14 (9%) patients, serum creatinine remained elevated above the baseline. Thirty-three (21.2%) patients showed proteinuria (
n
 = 24) and microscopic hematuria (
n
 = 9).
Conclusions
AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Residual kidney damage post-COVID-19 in recovered AKI patients may increase the CKD burden.