Apr 23 Kidney disease is associated with in-hospital death of patients with COVID-19
Yichun Cheng, Ran Luo, Kun Wang, Meng Zhang, Zhixiang Wang, Lei Dong, Junhua Li, Ying Yao, Shuwang Ge and Gang Xu
ABSTRACT
In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China, and quickly spread to other areas of the world. Although diffuse alveolar damage and acute respiratory failure were the main characteristics, it is necessary to explore the participation of other organs.
Since information on kidney disease in patients with COVID-19 is limited, we determined the prevalence of acute kidney injury (AKI) in patients with COVID-19. Furthermore, we evaluated the association between markers of abnormal kidney function and mortality in patients with COVID-19.
This is a prospective cohort study of 701 COVID-19 patients admitted to a tertiary university hospital that also encompassed three affiliated hospitals after the major outbreak in Wuhan in 2020, of whom 113 (16,1%) died in Hospital.
The median age of patients was 63 years (interquartile range, 50-71), including 367 men and 334 women.
Upon admission:
- 43.9% of patients had proteinuria
- 26.7% had hematuria.
- The prevalence of elevated serum creatinine, elevated blood urea nitrogen, and estimated glomerular filtration rate below 60 ml/min/1.73m2 was 14.4, 13.1, and 13.1%, respectively.
During the study period:
- AKI occurred in 5,1% of patients.
Kaplan-Meier analysis showed that patients with kidney disease had a significantly increased risk of death in hospital:
- Proportional hazard regression confirmed that elevated baseline serum creatinine (hazard ratio: 2.10, 95% confidence interval: 1.36-3.26), elevated baseline blood urea nitrogen (3.97, 2.57-6.14), stage 1 AKI (1.90, 0.76-4.76), stage 2 (3.51, 1.49-8.26), stage 3 (4.38, 2.31-8.31), proteinuria 1+ (1.80, 0.81-4.00), 2 + ∼3 + (4.84, 2.00-11.70) and hematuria 1+ (2.99, 1.39-6.42), 2+∼3+ (5.56,2.58- 12.01) were independent risk factors for in-hospital death after adjusting for age, sex, disease severity, comorbidity, and cell count. leukocytes.
Therefore, our findings show that the prevalence of kidney disease on admission and the development of AKI during hospitalization in patients with COVID-19 is high and is associated with in-hospital mortality. Therefore, physicians should increase their knowledge of kidney disease in patients with severe COVID-19.