Short- and long-term outcomes of patients with COVID-19 and acute kidney injury
https://doi.org/10.15829/1728-8800-2023-3587
EDN: PFOBEA
Abstract
Aim. To evaluate the impact of acute kidney injury (AKI) on in-hospital (death) and long-term outcomes (rehospitalization or death within 30 days; death within 180 days) in hospitalized patients with coronavirus disease 2019 (COVID-19).
Material and methods. The registry of patients with COVID-19 was analyzed to identify risk factors (RFs) for mortality. Discharged patients were included in a prospective study. Outcomes were assessed by telephone contacts.
Results. The study included 1000 patients. The mortality rate was 20,8%, while AKI was registered in 29,6% of patients. According to multivariate analysis, AKI, regardless of other risk factors, increased the risk of death (hazard ratio (HR), 1,62, 95% confidence interval (CI): 1,08-2,44, p=0,02). The prospective part included 691 patients. We revealed that 10% were rehospitalized or died within 30 days, while independent risk factors were age >65 years (HR, 2,72, 95% CI: 1,47-5,01, p=0,001) and AKI in the acute phase of COVID-19 (HR, 1,67, 95% CI: 1,00-2,80, p=0,05). In addition, 6% of patients died within 180 days, while AKI was the risk factor for death according to univariate analysis; the only independent predictor was age >65 years (HR, 5,96, 95% CI: 2,26-15,72, p<0,001).
Conclusion. AKI during the acute period of COVID-19, independently of other risk factors, more than 1,5 times increases the risk of mortality and the risk of adverse outcome within 30 days after discharge.
About the Authors
Yu. V. Khruleva
Patrice Lumumba Peoples’ Friendship University of Russia
Russian Federation
Russian Federation
Moscow
M. A. Efremovtseva
Patrice Lumumba Peoples’ Friendship University of Russia
Russian Federation
Russian Federation
Moscow
Yu. A. Timofeeva
Patrice Lumumba Peoples’ Friendship University of Russia
Russian Federation
Russian Federation
Moscow
M. V. Vatsik-Gorodetskaya
V.V. Vinogradov City Clinical Hospital
Russian Federation
Russian Federation
Moscow
Zh. D. Kobalava
Patrice Lumumba Peoples’ Friendship University of Russia
Russian Federation
Russian Federation
Moscow
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Supplementary files
What is already known about the subject?
- Acute kidney injury (AKI) in hospitalized patients with COVID-19 is common and associated with poor short-term outcomes.
What might this study add?
- AKI during hospitalization of patients with COVID-19 independently increases the risk of inhospital death and readmission or all-cause death within 30 days.
- AKI increases the risk of death in this group of patients within 180 days after discharge.
Review
For citations:
Khruleva Yu.V., Efremovtseva M.A., Timofeeva Yu.A., Vatsik-Gorodetskaya M.V., Kobalava Zh.D. Short- and long-term outcomes of patients with COVID-19 and acute kidney injury. Cardiovascular Therapy and Prevention. 2023;22(6):3587. (In Russ.) https://doi.org/10.15829/1728-8800-2023-3587. EDN: PFOBEA
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