COVID-19 Associated Acute Kidney Injury: The Incidence and Associated Factors in Different KDIGO Stages Among the Hospitalized Patients

Acute kidney injury (AKI) is the most common reported renal complication associated with COVID-19. In this study, we evaluated the frequency of AKI, the predisposing factors, and its impact on the patient’s outcomes in COVID-19.

Methods:

 By collecting retrospective data, we conducted a crosssectional study on hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients in a COVID-19- designated hospital in Shiraz, Iran, from March 2020 to June 2020. Patients’ characteristics and laboratory findings were recorded in data gathering sheets. Data were analyzed using SPSS Software Version 16. A P value < .05 was considered significant.

This study was conducted on 980 patients with COVID-19 (mean age: 51.2 ± 16.2 years and men: 54.8%), of which 32.6% developed AKI during their hospitalization period, and 1.3% ended up requiring renal replacement therapy. Patients with higher AKI stages experienced more severe/critical COVID-19 (stage 3:71.0%, stage 2: 44.8%, stage 1: 6.5%; P < .001). The multivariate analysis showed that the proteinuria had the highest relationship with AKI (OR = 6.77 [95% CI: 4.39 to 10.41], P < .001), followed by in-hospital death (OR = 5.14 [95% CI: 1.86 to 14.47], P = .002). In addition, in-hospital death was more observed in higher stages of AKI (OR = 12.69 [95% CI: 3.85 to 42.09], P < .001).

Hospitalized patients with COVID-19 are vulnerable to AKI, especially those who experienced more severe COVID-19 or require mechanical ventilation, which considerably affects the patients’ mortality. The high incidence of AKI in our patients demonstrated that it should be considered as one of the common complications of COVID-19, and diagnostic measures, particularly in severe or critical cases, are recommended.