TY - JOUR
AU - Sullivan, Michael K.
AU - Lees, Jennifer S.
AU - Drake, Thomas M.
AU - Docherty, Annemarie B.
AU - Oates, Georgia
AU - Hardwick, Hayley E.
AU - Russell, Clark D.
AU - Merson, Laura
AU - Dunning, Jake
AU - Nguyen-Van-Tam, Jonathan S.
AU - Openshaw, Peter J.M.
AU - Harrison, Ewen M.
AU - Baillie, J. Kenneth
AU - ISARIC4C Investigators
AU - Semple, Malcolm G.
AU - Ho, Antonia
AU - Mark, Patrick B.
PY - 2021
DA - October
TI - Acute kidney injury in patients hospitalised with COVID-19 from the ISARIC WHO CCP-UK Study: a prospective, multicentre cohort study
JO - Nephrology Dialysis Transplantation
DO - https://doi.org/10.1093/ndt/gfab303
AB - 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.
PB - Oxford University Press
UR - http://eprints.gla.ac.uk/252247/
KW - Coronavirus (COVID-19)
KW - Hospital care
ER