ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0705

Risk Factors for AKI in Patients Hospitalized with COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • No subcategory defined

Authors

  • Nadamuni, Mridula, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Liu, Yu-Lun, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Khan, Sadaf S., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Shastri, Shani, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Willett, Duwayne L., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Rajora, Nilum, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Chen, Catherine, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Hedayati, Susan, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
Background

We evaluated risk factors and prevalence associated with AKI in our early experiences with patients hospitalized with COVID-19, 32% of whom required ICU level care, at the University of Texas Southwestern and Parkland Hospitals in Dallas, Texas from 3/13/20-5/07/20.

Methods

Patients admitted with COVID-19 confirmed by SARS-CoV2 PCR test were screened for AKI. Univariate and multivariate logistic regression using backward selection identified factors associated with AKI.

Results

COVID-19 was confirmed in 145 patients, of whom 62 (43%) had AKI. Patients with AKI were older, mean (SD) age 60 (17) vs. 54 (15) years without AKI, p=0.03, and were more likely to have hypertension, 74% vs. 47%, p=0.002, and diabetes mellitus, 61% vs. 31%, p<0.001. CKD was present in 42% of those with AKI vs. 7% of those without, p<0.001. Race, ethnicity, and ACEI/ARB use did not differ between groups. Patients with AKI had higher CRP, median (IQR) 102 (44-161) vs. 59 (21-116) mg/L, p=0.009, and LDH on presentation, 365 (265-493) vs. 317 (228-385) U/L, p=0.04. Ferritin, IL-6, and D-dimer was similar between groups. A higher percent with AKI received steroids, 42% vs. 16%, p<0.001. Tocilizumab was administered in 15% of AKI vs. 5% of non-AKI groups, p=0.08 while rates of hydroxychloroquine and remdesivir use did not differ. Renal replacement therapy was required in 8 patients with AKI, of whom 7 received CVVHDF and 1 HD. There were 8 (13%) deaths in those with AKI vs. 5 (6%) in those without. Factors associated with AKI are listed (Table).

Conclusion

During the first weeks of COVID-19 outbreak at our hospitals, 43% of patients had AKI. Underlying CKD, diabetes, steroid use and illness severity were independently associated with AKI. Follow-up is needed to determine the long-term impact on kidney function and recovery.

VariableUnivariate OR (95% CI)PMultivariate OR (95% CI)P
Age (year)1.02 (1.00, 1.05)0.03--
HTN3.24 (1.59, 6.62)0.001--
CKD9.27 (3.51, 24.50)<0.0015.94 (1.78, 19.78)0.004
DM3.47 (1.74, 6.92)<0.0012.90 (1.15, 7.26)0.02
CRP1.01 (1.00, 1.01)0.03--
D-Dimer1.23 (1.02, 1.48)0.03--
LDH1.00 (1.00, 1.01)0.03--
Steroids3.82 (1.76, 8.35)0.0015.33 (1.88,15.10)0.002
Tocilizumab3.35 (0.98,11.45)0.05--
ICU2.43 (1.19, 4.95)0.014.01 (1.60, 10.07)0.003