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Kidney Week

Abstract: PO0088

Urinalysis and Urine Electrolytes Among Patients with COVID-19 Infection and AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Potluri, Vishnu S., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Lohani, Sadichhya, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Lindsay-McGinn, Forrest F., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Centeno, Claire A., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Morganroth, Jennifer, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Moore, Christy, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Teran, Felipe, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Reisinger, Nathaniel C., University of Pennsylvania, Philadelphia, Pennsylvania, United States
Background

Determining intravascular volume status for patients who have COVID-19 infection and AKI is critical for guiding decisions about fluid management and treating AKI. In this study, we present data on urinalysis and urine electrolytes among patients with COVID-19 infection who developed AKI at our hospital.

Methods

This is a cohort of patients with COVID-19 who were diagnosed with AKI at our center in Spring of 2020 and had a urinalysis performed within 48 hours of diagnosis of AKI. When applicable we used Mann-Whitney test to compare groups.

Results

34 patients had AKI, 21 (61%) were female, and 21 (61%) were Black race. All patients had a urinalysis, 23 (68%) had a urine sodium (UNa), and a 21 (61%) had a urine FeNa (fractional excretion of sodium). The median urine specific gravity (SG) was 1.019 (IQR 1.04 – 1.026). The median UNa was 39 (IQR 24 - 55). The median FeNa was 0.69% (IQR 0.18% - 1.07%). Figure 1 shows the distribution of urine SG by FeNa. The median serum creatinine at the time of diagnosis was 2.42 (IQR 1.52 - 3.92). A diagnosis of ATI (acute tubular injury) was made by the treating physician in 17 (50%) patients. The median creatinine at the time of diagnosis for patients who were diagnosed with ATI was 3.35 (IQR 2.29 – 5.16), and for those without ATI was 1.61 (IQR 1.48 - 2.63), p-value 0.0641. The median FeNa for patients who were diagnosed with ATI was 0.85% (IQR 0.56%-1.97%), and for those without ATI was 0.33% (IQR .12%-1.27%), p-value 0.105.

Conclusion

In our cohort, the majority of patients with AKI had urine studies consistent with volume depletion, suggesting that volume depletion is common. Implementation of urine studies in COVID-19 patients as part of regular care might help guide treating physicians deciding about fluid management.