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Abstract: PO0689

Community and Hospital-Acquired AKI in COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Martinez-Rueda, Armando Jezael, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Mejia, Juan M., Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Arvizu-Hernandez, Mauricio, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Alvarez, Rigoberto Doroteo, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Berman, Nathan, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Gaytan, Jorge, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Méndez, Rossa Angelica, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Fernandez, Dheni, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Flores Camargo, Areli Anahi, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Correa-Rotter, Ricardo, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
  • Vega, Olynka, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Tlalpan, DF, Mexico
Background

AKI is a frequent complication of COVID-19. We describe characteristics of patients with COVID-19 who developed both, community-acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI) in a Mexico City reference COVID-19 center.

Methods

We included data from all consecutive patients hospitalized between March 16th - May 29th 2020, with pneumonia and positive SARS-CoV-2 by RT-PCR test. Only data from patients who finished follow-up (n=636) was analyzed. AKI was defined according to KDIGO and ESKD patients (n=6) were excluded. Clinical and demographic characteristics of those with CA-AKI, HA-AKI, and non-AKI were compared by non-parametric ANOVA.

Results

Of 630 COVID-19, AKI was detected in 164 (26%), 81 (49%) CA-AKI, and 83 (51%) HA-AKI. Among AKI, 84 (51%) were Stage 1, 38 (23%) Stage 2, and 42 (26%) Stage 3. Stage 3 was more frequently observed in HA-AKI (p<0.001). RRT was provided to 15 (9.1%) at a median 3 days from diagnosis. Fluid overload was the main indication for RRT initiation. In general, AKI was associated with higher severity of COVID-19 evidenced by several risk scores, ICU admission, mechanical ventilation, and vasopressor therapy. Recovery from AKI was more frequent in the CA-AKI group 66% vs 44 % (p<0.001), and often associated to volume depletion reverted with fluid management. Among patients with AKI, 92 (56%) died, 49% in the CA-AKI vs. 63% in the HA-AKI group (p<0.001). There were no differences in RAAS inhibitor use between groups.

Conclusion

CA-AKI and HA-AKI are frequent renal manifestations in COVID-19. AKI is associated with more severe COVID-19 and significantly higher mortality. Although more comorbidities were present in CA-AKI, outcomes were better for CA-AKI vs. HA-AKI, in spite the latter group being younger, as it represents ICU patients with severe COVID-19 disease and associated multiorgan failure.