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Kidney Week

Abstract: TH-PO904

The Emergence of CKD After COVID-19 Related AKI

Session Information

  • COVID-19: Long COVID
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Terzian Ganadjian, Thiago, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Pereira Leite Nakamura, Vinicius, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Silva, Beatriz Moreira, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Clemente, Otavio Henrique, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Domingues, Bárbara Formaggio, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Andrade, Jessica Liara Felicio de, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Rodrigues, Adelson, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Goes, Miguel Angelo, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
Background

Acute kidney injury (AKI) can eventually progress into chronic kidney disease (CKD) and end-stage kidney disease (ESKD). COVID-19 is a multisystemic disorder that often causes AKI. The purpose of this study is to assess the frequency and association of clinical variables in patients who developed CKD and ESKD after COVID-19-related AKI.

Methods

We performed a one-year follow-up study with 182 survivor patients admitted to the ward and intensive care unit (ICU) with COVID-19 between April 2020 and March 2021 at Hospital São Paulo, Brazil. Patients aged ≥ 18 years with COVID-19 confirmed on RT-PCR were included. Patients with ESKD before hospitalization were excluded. AKI and CKD were defined according to the KDIGO criteria. We evaluated the frequency of AKI. After it, we compared some clinical variables and outcomes in two sub-groups: CKD after CoV-AKI, and non-CKD after COVID-19. Univariate and multivariate analyses were performed.

Results

137 (75.3%) patients developed AKI. Of these, 56 (30.8%) needed kidney replacement terapy (KRT) in-hospital. There were higher frequencies of diabetes and hypertension with lower eGFR (84.2±24.9, 94.4±29.9 ml/min; p=0.08) and mean arterial pressure (74.9±9.6, 79.1±7.7 mmHg; p=0.03) at baseline in CKD after CoV-AKI group. Hypertension was independently associated with CKD in binary logistic regression [OR: 4.472, 95% CI:1356-13886; p=0.001]. We further observed that all patients who progressed to ESKD (n=7; 3.9%) had non-dialytic CKD exacerbated by COVID-19 requiring KRT.

Conclusion

Hypertension was the independent clinical factor associated with progression to CKD after COVID-19- related AKI. All patients who progressed to ESKD had CKD exacerbated by COVID-19 requiring KRT.