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Abstract: PO0047

COVID-19-Associated Kidney Injury: A Single-Center Community Experience of 684 Consecutive Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Mueller, Dana, Advocate Christ Medical Center, Oak Lawn, Illinois, United States
  • Calimag, Angela Pauline P., Advocate Christ Medical Center, Oak Lawn, Illinois, United States
  • Guglielmi, Anthony, Advocate Christ Medical Center, Oak Lawn, Illinois, United States
  • Youssef, Caroline, Advocate Christ Medical Center, Oak Lawn, Illinois, United States
  • Deleveaux, Spencer, Advocate Christ Medical Center, Oak Lawn, Illinois, United States
  • Raju, Vinay, Advocate Christ Medical Center, Oak Lawn, Illinois, United States
  • Lerma, Edgar V., Advocate Christ Medical Center, Oak Lawn, Illinois, United States
Background

Acute kidney injury associated with COVID-19 is poorly understood; majority of the published literature currently available in the United States comes from major academic institutions. This study aims to describe the epidemology and general outcomes of hospitalized patients with COVID-19 at a large tertiary community hospital.

Methods

This is retrospective descriptive study of the incidence of acute kidney injury for hospitalized patients with COVID-19 between March 1st - May 31st at a single-center community teaching hospital in Cook County, Illinois. Patients diagnosed previously with End Stage Renal Disease (ESRD) and kidney transplant recipients were excluded, as were incidental positives and multiple COVID-19 hospitalizations. Acute kidney injury (AKI) was defined by KDIGO criteria. Baseline creatinine (SCr) was defined as the median SCr from the previous 365 days until 7 days prior to admission. If no baseline SCr was available, admission SCr was used as the baseline. Results are descriptive.

Results

Of the 684 patients admitted the hospital with COVID-19 infections, 231 (33.8%) developed an AKI. Stage 1 129 (55.8%), Stage 2 36 (15.6%), Stage 3 66 (28.6%). Urine microscopy showed proteinuria 104 (45.1%), hematuria 129 (55.8%), leukocyturia 129 (55.8%); Median FE Na 0.3 [0.1 - 0.7] and FE Urea 21.1 [15.0 - 29.5]. Renal biopsy performed on four patients demonstrated acute tubular necrosis. Fifty-two (22.5%) patients received KRT; most commonly with CKRT in 26 (50%) or combination of CKRT and HD in 17 (32.7%). Median hospital day for initial dialysis was 5.0 [2.0 - 10.0]; mechanical ventilation 0.0 [1 .0- 4.0], ECMO 1.0 [0 - 4]. LOC was significantly longer for AKI patients (overall 8.7 [4.8 - 17.3], No AKI 7.7 [4.0 - 12.7], AKI 15.0 [7.1 - 27.2] days p <0.01). Most common co morbidities were Type 2 diabetes and hypertension. D-dimer, LDH, CRP, procalcitonin and IL-6 were significantly higher. Upon discharge, 138 (59.7%) were discharged without KRT, whereas 12 (5.2%) patients required KRT. Nine (3.9%) went hospice, and 72 (31.2%) died. One patient was still admitted to the hospital.

Conclusion

Acute kidney injury is a poor prognostic indicator for patients with COVID-19. The mortality rates and outcomes of patients with AKI in this setting are comparable to previously published studies.