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Abstract: PO0676

AKI in Patients with COVID-19 Infection: Preliminary Data from AKI COVID-19 Registry of the Spanish Society of Nephrology

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Soler, Maria Jose, Hospital Vall d Hebron, Barcelona, BARCELONA, Spain
  • Poch, Esteban, Hospital Clínic de Barcelona., Barcelona, Catalunya, Spain
  • Diaz Mancebo, Raquel, Hospital de la Paz, Madrid, Spain
  • Echarri, Rocío Echarri, Hospital Universitario Infanta Sofia., San Sebastian de los Reyes, Madrid, Spain
  • Areste, Nuria, Hospital Universitario Virgen Macarena., Sevilla, Spain
  • Salgueira Lazo, Mercedes, Hospital Universitario Virgen Macarena., Sevilla, Spain

Group or Team Name

  • AKI COVID-19 Registry of the Spanish Society of Nephrology.
Background

SARS-CoV-2 coronavirus pandemic has significant impact on the general population, and chronic hemodialysis patients presented a poor prognosis with a mortality rate around 25%. Data from severe acute kidney injury(AKI) and acute renal replacement therapy(RRT) is scarce. We present the preliminary results of AKI COVID-19 Registry of the Spanish Society of Nephrology.

Methods

The online Registry began operating on May 21th. It collects epidemiological variables, contagion and diagnosis data, signs and symptoms, treatments and outcomes. Patients were diagnosed with SARS-Cov-2 infection based on PCR of the virus.

Results

One week after the AKI COVID registry started, 54 patients with AKI with RRT and COVID-19 from 11 Hospitals. Age was 64+9years and 55% men. 65% hypertension, 31% diabetes mellitus, 14% cardiovascular disease, 26% chronic kidney disease, 6% neoplasm, 29% obesity, 8% chronic obstructive pulmonary disease, and 6% smokers. Previous treatment: 10% immunosuppressive, 20% ACEi, 25% ARBs, 14% antiplatelets, and 10% anticoagulants. Clinical characteristics: 92% common respiratory symptoms, 96% pneumonia, 90% required intensive care unit(ICU) and 87% mechanic ventilation. 32% albuminuria, 18% hematuria, and 50% AKI with preserved urine output. Time from COVID-19 symptoms start to AKI 12.3+8days, time ICU 19.8+5days. APACHE at UCI admission 15+7. 81% lymphopenia. RRT was needed in 91% 13.4+12days: 55% received continuous RRT, and 72% anticoagulation. Kidney biopsy was not performed. Mortality 46.3% (60% males), and 4% remained under RRT. Time from AKI to renal function recovery 25+14 days. 65.2% death patients had hypertension. No differences were observed in comorbidities, chronic treatments, renal clinical characteristics, dialysis modality and mortality. Decreased lymphocyte count was associated with worse patient prognosis (dead 495±260 vs. survivors 789±460,p=0.023).

Conclusion

The mortality in AKI with RRT and COVID-19 is alarming high. Severe AKI associated with COVID-19 disease is more frequent in males. Interestingly, half of the patients preserved urine output. Severe lymphopenia was associated with mortality. More data from the AKI COVID-19 registry will help us to enlighten the prognosis and risk factors associated to mortality.

Funding

  • Government Support - Non-U.S.