@article{Sullivan_M-2021_45912,
title = {Acute kidney injury in patients hospitalised with COVID-19 from the ISARIC WHO CCP-UK Study: a prospective, multicentre cohort study},
author = {Sullivan, M. and Lees, J. and Drake, T. and Docherty, A. and Oates, G. and Hardwick, H. and Russell, C. and Merson, L. and Dunning, J. and Nguyen-Van-Tam, J. and Openshaw, P. and Harrison, E. and Baillie, J. and ISARIC4C Investigators and Semple, M. and Ho, A. and Mark, P.},
month = {oct},
year = {2021},
abstract = {Background: Acute kidney injury (AKI) is common in COVID-19. This study investigated adults hospitalised with COVID-19 and hypothesised that risk factors for AKI would include co-morbidities and non-white race.  Methods: A prospective multicentre cohort study was performed using patients admitted to 254 UK hospitals with COVID-19 between January 17th 2020 and December 5th 2020.  Results: Of 85,687 patients, 2,198 (2.6%) received acute kidney replacement therapy (KRT). Of 41,294 patients with biochemistry data, 13,000 (31.5%) had biochemical AKI: 8,562 stage 1 (65.9%), 2,609 stage 2 (20.1%) and 1,829 stage 3 (14.1%). The main risk factors for KRT were chronic kidney disease (CKD: Adjusted odds ratio (aOR) 3.41: 95% confidence interval 3.06-3.81), male sex (aOR 2.43: 2.18-2.71) and black race (aOR 2.17: 1.79-2.63). The main risk factors for biochemical AKI were admission respiratory rate &gt;30 breaths per minute (aOR 1.68: 1.56-1.81), CKD (aOR 1.66: 1.57-1.76) and black race (aOR 1.44: 1.28-1.61). There was a gradated rise in the risk of 28-day mortality by increasing severity of AKI: stage 1 aOR 1.58 (1.49-1.67); stage 2 aOR 2.41 (2.20-2.64); stage 3 aOR 3.50 (3.14-3.91); KRT aOR 3.06 (2.75-3.39). AKI rates peaked in April 2020 and the subsequent fall in rates could not be explained by the use of dexamethasone or remdesivir.  Conclusions: AKI is common in adults hospitalised with COVID-19 and it is associated with a heightened risk of mortality. Although the rates of AKI have fallen from the early months of the pandemic, high-risk patients should have their kidney function and fluid status monitored closely.},
journal = {Nephrology Dialysis Transplantation},
publisher = {Oxford University Press},
url = {https://doi.org/10.1093/ndt/gfab303},
}
