Savaş Öztürk1, Kenan Turgutalp2, Mustafa Arıcı3, Hakkı Çetinkaya4, Mehmet Rıza Altıparmak5, Zeki Aydın6, Zeki Soypaçacı7, Feyza Bora8, Ekrem Kara9, Egemen Cebeci1, Tuba Elif Özler10, Mürşide Esra Dölarslan11, Savaş Sipahi12, Yavuz Ayar13, İdris Şahin14, Serkan Bakırdöğen15, Mahmud İslam16, Numan Görgülü17, Melike Betül Öğütmen18, Erkan Şengül19, Özkan Güngör20, Nurhan Seyahi5, BÜlent Tokgöz21, Ali Rıza Odabaş4, Halil Zeki Tonbul22, Siren Sezer23, Alaattin Yıldız24, Kenan Ateş25. 1. Department of Nephrology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey 2. Department of Internal Medicine, Division of Nephrology, Mersin University Faculty of Medicine, Training and Research Hospital, Mersin, Turkey 3. Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey 4. Department of Nephrology, Sultan 2. Abdulhamid Han Training and Research Hospital, University of Health Sciences, İstanbul, Turkey 5. Department of Internal Medicine, Division of Nephrology, Cerrahpaşa Faculty of Medicine, İstanbul University–Cerrahpaşa, İstanbul, Turkey 6. Department of Nephrology, Darıca Farabi Training and Research Hospital, Kocaeli, Turkey 7. Department of Internal Medicine, Division of Nephrology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey 8. Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Akdeniz University, Antalya, Turkey 9. Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey 10. Department of Internal Medicine, Division of Nephrology, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, İstanbul, Turkey 11. Department of Nephrology, Trabzon Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey 12. Department of Internal Medicine, Division of Nephrology, Sakarya University Training and Research Hospital, Sakarya, Turkey 13. Department of Nephrology, Bursa City Hospital, Bursa, Turkey 14. Department of Internal Medicine, Division of Nephrology, Turgut Özal Medical Center, İnönü University Faculty of Medicine, Malatya, Turkey 15. Department of Internal Medicine, Division of Nephrology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey 16. Department of Nephrology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey 17. Department of Internal Medicine, Division of Nephrology, Bağcılar Training and Research Hospital, University of Health Sciences, İstanbul, Turkey 18. Department of Nephrology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, İstanbul, Turkey 19. Department of Nephrology, Kocaeli Derince Training and Research Hospital, University of Health Sciences, Kocaeli, Turkey 20. Department of Nephrology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey 21. Department of Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey 22. Department of Nephrology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey 23. Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Atılım University, Ankara, Turkey 24. Department of Internal Medicine, Division of Nephrology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey 25. Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkey
Abstract
Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3–5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47–73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9–44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9–33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients. This work is licensed under a Creative Commons Attribution 4.0 International License.
Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3–5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47–73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9–44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9–33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKDpatients. This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors: Yasar Caliskan; Seyedmahdi Pahlavani; Ariel Schnell; Aliza Anwar Memon; Fadee Abu Al Rub; Usama Elewa; Marie Philipneri; Kana Miyata; Thanh-Mai Vo; Amy Mosman; Thomas Groll; John Edwards; Krista L Lentine Journal: Turkish J Nephrol Date: 2022-07
Authors: Katarzyna Kilis-Pstrusinska; Katarzyna Akutko; Joanna Braksator; Anna Dancewicz; Patrycja Grosman-Dziewiszek; Tatiana Jamer; Katarzyna Juszczyńska; Klaudia Konikowska; Marta Koruba; Małgorzata Pupek; Agnieszka Rusiecka; Krzysztof Kujawa; Barbara Adamik; Adrian Doroszko; Krzysztof Kaliszewski; Agnieszka Matera-Witkiewicz; Michał Pomorski; Marcin Protasiewicz; Janusz Sokołowski; Katarzyna Madziarska; Ewa A Jankowska Journal: J Clin Med Date: 2021-11-25 Impact factor: 4.241