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Abstract: PO0019

Burdens of AKI and CKD Among COVID-19 Survivors

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Xie, Yan, VA Saint Louis Health Care System Clinical Epidemiology Center, Saint Louis, Missouri, United States
  • Bowe, Benjamin Charles, VA Saint Louis Health Care System Clinical Epidemiology Center, Saint Louis, Missouri, United States
  • Gibson, Andrew K., VA Saint Louis Health Care System Clinical Epidemiology Center, Saint Louis, Missouri, United States
  • Xu, Evan, VA Saint Louis Health Care System Clinical Epidemiology Center, Saint Louis, Missouri, United States
  • Al-Aly, Ziyad, VA Saint Louis Health Care System Clinical Epidemiology Center, Saint Louis, Missouri, United States
Background

COVID-19 is known to be associated with increased risk of acute kidney injury (AKI) during the acute phase of the infection. However, the burden of AKI and chronic kidney diseases (CKD) after the first 30 days of COVID-19 infection is not clear.

Methods

181,384 COVID-19 patients from the United States Veterans Health Care System who survived the first 30 days of infection were enrolled and compared with 4,397,509 non-infected controls on burden of AKI and CKD at 6 months. Adjusted comparisons were conducted across severity of infection measured based on intensity of care received, and by subgroups based on age and pre-existing health conditions.

Results

With a median follow up of 150 (interquartile range: 115, 221) days, the adjusted excess burden of AKI due to COVID-19 was 6.07 (95% confidence interval: 5.46, 6.69) and excess burden of CKD was 7.19 (5.78, 8.55) per 1000 persons at 6 months. The excess burden of AKI increased with the severity of acute infection(excess burden 1.28 (0.68, 1.86), 28.11 (25.94, 30.26) and 73.18 (67.53, 79.02) per 1000 persons at 6 months for COVID-19 patients without hospitalization, hospitalized and admitted to intensive care units, respectively). The excess burdens of CKD were 1.66 (0.19, 3.08), 36.41 (31.71, 41.11) and 82.55 (71.93, 93.78) for those not hospitalized, hospitalized and admitted to intensive care units, respectively. The burden of AKI and CKD increased with increased age (≤60, 60-70, >70 years) and increased pre-existing health conditions (Charlson comorbidity index of 0, 1-3 and >3) (Table).

Conclusion

Our results suggest that COVID-19 survivors, including those without hospitalization or pre-existing health conditions, suffered burden of AKI and CKD after the first 30 days of the infection. We provide insight into the burdens of AKI and CKD by population groups; our estimates may help guide nephrology care for COVID-19 patients.

PopulationAKI
Adjusted excess burden per 1000 persons at 6 months
(95% Confidence interval)
CKD
Adjusted excess burden per 1000 persons at 6 months
(95% Confidence interval)
Overall6.07
(5.46, 6.69)
7.19
(5.78, 8.55)
Age (years)≤ 601.33
(0.81, 1.86)
0.87
(0.18, 1.57)
60-706.36
(5.15, 7.69)
6.53
(4.02, 9.11)
>7012.32
(11.12, 13.58)
19.24
(15.43, 23.14)
Charlson comorbidity index02.62
(2.14, 3.14)
3.60
(2.42, 4.75)
1-38.87
(7.91, 9.88)
10.57
(8.08, 13.08)
>325.07
(21.82, 28.42)
20.17
(13.92, 26.75)
Outcomes were ascertained from 30 days after COVID-19 infection until end of follow-up.
Excess burden estimated as the burden difference between COVID-19 and control groups per 1000 persons at 6 months.

Funding

  • Veterans Affairs Support