Hong Xu1, Sara Garcia-Ptacek2,3, Martin Annetorp3, Annette Bruchfeld4,5,6, Tommy Cederholm3,7, Peter Johnson8, Miia Kivipelto2,3, Carina Metzner3, Dorota Religa2,3, Maria Eriksdotter2,3. 1. Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, NEO, Blickagången 16, Huddinge, 141 52, Stockholm, Sweden. hong.xu.2@ki.se. 2. Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, NEO, Blickagången 16, Huddinge, 141 52, Stockholm, Sweden. 3. Theme Aging, Karolinska University Hospital, Stockholm, Sweden. 4. Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. 5. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden. 6. Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden. 7. Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. 8. Department of Geriatrics, Capio Geriatrik Nacka AB, Nacka, Sweden.
Abstract
BACKGROUND: Research regarding COVID-19 and acute kidney injury (AKI) in older adults is scarce. We evaluated risk factors and outcomes of AKI in hospitalized older adults with and without COVID-19. METHODS: Observational study of patients admitted to two geriatric clinics in Stockholm from March 1st to June 15th, 2020. The difference in incidence, risk factors and adverse outcomes for AKI between patients with or without COVID-19 were examined. Odds ratios (OR) for the risk of AKI and in-hospital death were obtained from logistic regression. RESULTS: Three hundred-sixteen older patients were hospitalized for COVID-19 and 876 patients for non-COVID-19 diagnoses. AKI occurred in 92 (29%) patients with COVID-19 vs. 159 (18%) without COVID-19. The odds for developing AKI were higher in patients with COVID-19 (adjusted OR, 1.70; 95% confidence interval [CI] 1.04-2.76), low baseline kidney function as depicted by estimated glomerular filtration rate (eGFR) [4.19 (2.48-7.05), for eGFR 30 to < 60 mL/min, and 20.3 (9.95-41.3) for eGFR < 30 mL/min], and higher C reactive protein (CRP) (OR 1.81 (1.11-2.95) in patients with initial CRP > 10 mg/L). Compared to patients without COVID-19 and without AKI, the risk of in-hospital death was highest in patients with COVID-19 and AKI [OR 80.3, 95% CI (27.3-235.6)], followed by COVID-19 without AKI [16.3 (6.28-42.4)], and by patients without COVID-19 and with AKI [10.2 (3.66-28.2)]. CONCLUSIONS: Geriatric patients hospitalized with COVID-19 had a higher incidence of AKI compared to patients hospitalized for other diagnoses. COVID-19 and reduced baseline kidney function were risk factors for developing AKI. AKI and COVID-19 were associated with in-hospital death.
BACKGROUND: Research regarding COVID-19 and acute kidney injury (AKI) in older adults is scarce. We evaluated risk factors and outcomes of AKI in hospitalized older adults with and without COVID-19. METHODS: Observational study of patients admitted to two geriatric clinics in Stockholm from March 1st to June 15th, 2020. The difference in incidence, risk factors and adverse outcomes for AKI between patients with or without COVID-19 were examined. Odds ratios (OR) for the risk of AKI and in-hospital death were obtained from logistic regression. RESULTS: Three hundred-sixteen older patients were hospitalized for COVID-19 and 876 patients for non-COVID-19 diagnoses. AKI occurred in 92 (29%) patients with COVID-19 vs. 159 (18%) without COVID-19. The odds for developing AKI were higher in patients with COVID-19 (adjusted OR, 1.70; 95% confidence interval [CI] 1.04-2.76), low baseline kidney function as depicted by estimated glomerular filtration rate (eGFR) [4.19 (2.48-7.05), for eGFR 30 to < 60 mL/min, and 20.3 (9.95-41.3) for eGFR < 30 mL/min], and higher C reactive protein (CRP) (OR 1.81 (1.11-2.95) in patients with initial CRP > 10 mg/L). Compared to patients without COVID-19 and without AKI, the risk of in-hospital death was highest in patients with COVID-19 and AKI [OR 80.3, 95% CI (27.3-235.6)], followed by COVID-19 without AKI [16.3 (6.28-42.4)], and by patients without COVID-19 and with AKI [10.2 (3.66-28.2)]. CONCLUSIONS: Geriatric patients hospitalized with COVID-19 had a higher incidence of AKI compared to patients hospitalized for other diagnoses. COVID-19 and reduced baseline kidney function were risk factors for developing AKI. AKI and COVID-19 were associated with in-hospital death.
Authors: Michael Anthonius Lim; Raymond Pranata; Ian Huang; Emir Yonas; Arto Yuwono Soeroto; Rudi Supriyadi Journal: Can J Kidney Health Dis Date: 2020-07-07
Authors: Edouard L Fu; Roemer J Janse; Ype de Jong; Vera H W van der Endt; Jet Milders; Esmee M van der Willik; Esther N M de Rooij; Olaf M Dekkers; Joris I Rotmans; Merel van Diepen Journal: Clin Kidney J Date: 2020-09-02
Authors: L Kananen; M Eriksdotter; A M Boström; M Kivipelto; M Annetorp; C Metzner; V Bäck Jerlardtz; M Engström; P Johnson; L G Lundberg; E Åkesson; C Sühl Öberg; S Hägg; D Religa; J Jylhävä; T Cederholm Journal: Clin Nutr Date: 2021-07-29 Impact factor: 7.324