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Abstract: FR-PO021

COVID-19-Associated AKI in Hospitalized Patients: Incidence, Risk Factors, and Outcomes in a Tertiary Care Center in Thailand

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Phisalwut, Suphanan, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Siriwattanasit, Narongrit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Inkong, Pitchamon, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Varothai, Narittaya, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Thimachai, Paramat, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Tasanavipas, Pamila, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Chaiprasert, Amnart, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Nata, Naowanit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Tangwonglert, Theerasak, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Kaewput, Wisit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Supasyndh, Ouppatham, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao College of Medicine, Bangkok, Thailand
Background

Acute kidney injury (AKI) is a common complication of COVID-19 and related with severity and outcomes. However, relatively little is known about risk factors of AKI and outcomes among Thai hospitalized patients with COVID-19. The study described the incidence of different stages of AKI, risk factors and renal outcomes in hospitalized COVID-19-associated AKI patients.

Methods

The observational study involved a review of data from health records of COVID-19 pneumonia patients aged ≥18 years in the tertiary care center from June 1 to September 30, 2021. We describe the frequency of AKI, dialysis requirement, and adjusted hazard ratios (adjusted HR) with AKI.

Results

A total of 966 hospitalized COVID-19 pneumonia patients, AKI occurred in 170 (17.5%) and AKI stage 1, 2 and 3 was 45.2% (N=77), 25.2% (N=43) and 29.4% (n =50). 23 patients (13% of AKI) required dialysis. The independent risk factors for AKI were pre-existing CKD (aHR 1.74, 95%CI 1.03-2.93), cardiovascular disease (aHR 2.42, 95%CI 1.38-4.24), serum ferritin (aHR 1.001, 95%CI 1.001-1.002), history of diuretic use (aHR 2.68, 95%CI 1.08-6.64), respiratory support (aHR 3.33, 95%CI 1.65-6.73), and presence of septic shock (aHR 3.23, 95%CI 1.59-6.56). 44.7% had non renal recovery. In-hospital mortality in AKI patients was 54.1%. An adjustment for demographics, and laboratory values, the aOR for death was 2 (95%CI, 1.01-4.05)

Conclusion

AKI is common among patients hospitalized with COVID-19 and is associated with non-renal recovery and death. The predisposing factors are pre-existing CKD, cardiovascular disease, history of diuretic use and more severe COVID-19 presentation.