Kidney involvement in patients with coronavirus disease 2019 (COVID-19) is common, and can range from the presence of proteinuria and haematuria to acute kidney injury (AKI) requiring renal replacement therapy (RRT; also known as kidney replacement therapy). COVID-19-associated AKI (COVID-19 AKI) is associated with high mortality and serves as an independent risk factor for all-cause in-hospital death in patients with COVID-19. The pathophysiology and mechanisms of AKI in patients with COVID-19 have not been fully elucidated and seem to be multifactorial, in keeping with the pathophysiology of AKI in other patients who are critically ill. Little is known about the prevention and management of COVID-19 AKI. The emergence of regional ‘surges’ in COVID-19 cases can limit hospital resources, including dialysis availability and supplies; thus, careful daily assessment of available resources is needed. In this Consensus Statement, the Acute Disease Quality Initiative provides recommendations for the diagnosis, prevention and management of COVID-19 AKI based on current literature. We also make recommendations for areas of future research, which are aimed at improving understanding of the underlying processes and improving outcomes for patients with COVID-19 AKI.


This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

Cite as

Nadim, M., Forni, L., Mehta, R., Connor, M., Liu, K., Ostermann, M., Rimmelé, T., Zarbock, A., Bell, S., Bihorac, A., Cantaluppi, V., Hoste, E., Husain-Syed, F., Germain, M., Goldstein, S., Gupta, S., Joannidis, M., Kashani, K., Koyner, J., Legrand, M., Lumlertgul, N., Mohan, S., Pannu, N., Peng, Z., Perez-Fernandez, X., Pickkers, P., Prowle, J., Reis, T., Srisawat, N., Tolwani, A., Vijayan, A., Villa, G., Yang, L., Ronco, C. & Kellum, J. 2020, 'COVID-19-associated acute kidney injury: Consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup', Nature Reviews Nephrology, 16, pp. 747-767. https://doi.org/10.1038/s41581-020-00356-5

Downloadable citations

Download HTML citationHTML Download BIB citationBIB Download RIS citationRIS
Last updated: 17 June 2022
Was this page helpful?