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Kidney Week

Abstract: TH-PO079

A Tertiary Care Centre Experience of COVID-19-Associated AKI During the First and Second Waves of the Pandemic

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Kumaresan, Maithrayie, University Hospital Lewisham, London, London, United Kingdom
  • Mogga, Phanidhar, MGM Healthcare, Chennai, Tamilnadu, India
  • Abraham, Georgi, MGM Healthcare, Chennai, Tamilnadu, India
  • Rajagopalan, Urjitha, MGM Healthcare, Chennai, Tamilnadu, India
Background

There is a scarcity of information on the incidence and outcomes of acute kidney injury in COVID-19 patients in India. Therefore, we analysed the correlation of AKI risk factors and compared the outcomes of the first and second COVID-19 waves in a tertiary care centre.

Methods

●Single centre retrospective analysis
●Patients who tested positive for COVID-19 between July 2020 and May 2021, with serum creatinine levels measured on admission (n= 1260).
●AKI was defined according to the KDIGO clinical practice guidelines.
●Multivariate binomial logistic regression yielded odds ratios for risk variables of AKI.
●Age-adjusted odds ratios(OR) were used to compare COVID-19 outcomes between the first and second waves.

Results

Baseline characteristics:
●Median Age= 56 (IQR 47-66)
●Population with diabetes-55.2%
●Population with hypertension-42.11%

All AKI (n=86)
●Stage 1 (n=57)
●Stage 2 (n=20)
●Stage 3 (n=9)

Risk factors for AKI:
●Diabetes OR 1.9 (1.2 – 3.1)
●Hypertension OR 3.2 (2.0 – 5.2)
●C-reactive protein ≥ 10 mg/dl, OR 3.6 (1.6 – 8.0).
●D-dimer ≥ 250 pg/ml, OR 4.2 (2.5 – 6.8).
●Need for ventilation OR 3.06 (1.8 – 4.9)

Comparison of COVID -19 outcomes:
Compared to the first wave, the second wave cohort had lower risk for:
●Acute kidney injury (adj OR: 0.4; CI: 0.2-0.7)
●Mortality (adj OR: 0.2; CI: 0.09-0.7)
●Invasive mechanical ventilation (adj OR: 0.2; CI: 0.06 - 0.8)
●Length of ICU stay > 5days (adj OR: 0.4; CI: 0.2 - 0.7)

Conclusion

In our retrospective study, AKI prevalence was 6.8%, and the mortality rate of 2.9%. Our analysis shows that the second wave of COVID -19 exhibits improved clinical outcomes compared to the first wave