AKI in Hospitalized Patients with COVID-19

被引：328

作者：

Chan, Lili ^{[1
,2
,3
,4
,5
]}

Chaudhary, Kumardeep ^{[3
,4
,5
]}

Saha, Aparna ^{[3
,4
]}

Chauhan, Kinsuk ^{[1
]}

Vaid, Akhil ^{[6
]}

Zhao, Shan ^{[6
,7
]}

Paranjpe, Ishan ^{[6
]}

Somani, Sulaiman ^{[6
]}

Richter, Felix ^{[5
,6
]}

Miotto, Riccardo ^{[5
,6
]}

Lala, Anuradha ^{[7
,8
]}

Kia, Arash ^{[9
,10
]}

Timsina, Prem ^{[9
,10
]}

Li, Li ^{[5
,11
]}

Freeman, Robert ^{[9
,10
]}

Chen, Rong ^{[5
,11
]}

Narula, Jagat ^{[12
,13
]}

Just, Allan C. ^{[14
]}

Horowitz, Carol ^{[2
,9
]}

Fayad, Zahi ^{[15
,16
]}

Cordon-Cardo, Carlos ^{[17
]}

Schadt, Eric ^{[5
,11
]}

Levin, Matthew A. ^{[7
]}

Reich, David L. ^{[7
]}

Fuster, Valentin ^{[8
]}

Murphy, Barbara ^{[1
,2
]}

He, John C. ^{[1
,2
]}

Charney, Alexander W. ^{[5
,18
,19
]}

Boettinger, Erwin P. ^{[6
]}

Glicksberg, Benjamin S. ^{[5
,6
]}

Coca, Steven G. ^{[1
,2
]}

Nadkarni, Girish N. ^{[1
,2
,3
,4
,6
]}

机构：

[1] Icahn Sch Med Mt Sinai, Dept Med, Div Nephrol, New York, NY 10029 USA

[2] Icahn Sch Med Mt Sinai, Dept Med, New York, NY 10029 USA

[3] Icahn Sch Med Mt Sinai, Charles Bronfman Inst Personalized Med, New York, NY 10029 USA

[4] Icahn Sch Med Mt Sinai, BioMe Phen Ctr, New York, NY 10029 USA

[5] Icahn Sch Med Mt Sinai, Dept Genet & Genom Sci, New York, NY 10029 USA

[6] Hasso Plattner Inst Digital Hlth Mt Sinai, New York, NY USA

[7] Icahn Sch Med Mt Sinai, Dept Anesthesiol Perioperat & Pain Med, New York, NY 10029 USA

[8] Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, New York, NY 10029 USA

[9] Icahn Sch Med Mt Sinai, Dept Populat Hlth Sci & Policy, New York, NY 10029 USA

[10] Icahn Sch Med Mt Sinai, Inst Healthcare Delivery Sci, New York, NY 10029 USA

[11] Icahn Sch Med Mt Sinai, Icahn Inst Data Sci & Genom Technol, New York, NY 10029 USA

[12] Icahn Sch Med Mt Sinai, Mt Sinai Heart, New York, NY 10029 USA

[13] Icahn Sch Med Mt Sinai, Dept Cardiol, New York, NY 10029 USA

[14] Icahn Sch Med Mt Sinai, Dept Environm Med & Publ Hlth, New York, NY 10029 USA

[15] Icahn Sch Med Mt Sinai, BioMed Engn & Imaging Inst, New York, NY 10029 USA

[16] Icahn Sch Med Mt Sinai, Dept Radiol, New York, NY 10029 USA

[17] Icahn Sch Med Mt Sinai, Dept Pathol, New York, NY 10029 USA

[18] Icahn Sch Med Mt Sinai, Pamela Sklar Div Psychiat Genom, New York, NY 10029 USA

[19] Icahn Sch Med Mt Sinai, Dept Psychiat, New York, NY 10029 USA

来源：

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2021年 / 32卷 / 01期

关键词：

acute renal failure; clinical nephrology; dialysis; COVID-19; ACUTE KIDNEY INJURY; ACUTE-RENAL-FAILURE; DISEASE; RECOVERY; RISK;

D O I：

10.1681/ASN.2020050615

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associatedwith worse outcomes. However, AKI among hospitalized patients with COVID19 in the United States is not well described. Methods This retrospective, observational study involved a review of data from electronic health records of patients aged >= 18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality. Results Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patientswith AKI required dialysis. The proportionswith stages 1, 2, or 3 AKIwere 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% had leukocyturia. Independent predictors of severe AKI were CKD, men, and higher serum potassium at admission. In-hospital mortality was 50% among patients with AKI versus 8% among those without AKI (aOR, 9.2; 95% confidence interval, 7.5 to 11.3). Of survivors with AKI who were discharged, 35% had not recovered to baseline kidney function by the time of discharge. An additional 28 of 77 (36%) patients who had not recovered kidney function at discharge did so on posthospital follow-up. Conclusions AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Of all patients with AKI, only 30% survived with recovery of kidney function by the time of discharge.

引用

页码：151 / 160

页数：10

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