Abstract: FR-PO1127
Long-Term Outcomes After AKI in Hospitalized Patients with COVID-19
Session Information
- COVID-19 - II
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Gameiro, Joana, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Marques da Silva, Bernardo, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Costa, Claudia, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Branco, Carolina, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Marques, Filipe, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Agapito Fonseca, José, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Lopes, Jose António, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
Background
Acute kidney injury (AKI) is frequent in hospitalized patients with COVID-19 and contributes to adverse short and long-term outcomes. We aimed to evaluate the association of AKI and long-term outcomes in a cohort of survivors of a hospitalization for COVID-19.
Methods
Single-centre and retrospective study of hospitalized patients admitted to a Dedicated Unit for COVID-19 at Centro Hospitalar Universitário Lisboa Norte, Portugal, between March 2020 and October 2020. AKI was defined and classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) classification, using SCr criteria. The analysed outcomes were development of major adverse kidney events (MAKE), major adverse renal cardiovascular events (MARCE), and mortality over a two-year follow-up period. MAKE was defined as a composite of death from any cause, renal replacement therapy dependence or worsened kidney function (decrease in eGFR to <25% of baseline and/or eGFR<60 mL/min/1.73m2). MARCE was defined as major adverse kidney event (death, RRT dependence or worsened renal function) and/or major adverse cardiovascular event (myocardial infarction, stroke, and heart failure).
Results
From the included 409 patients, AKI occurred in 60.4% (n=247). Within two years after discharge, 31.8% (n=130) of patients had an eGFR<60mL/min/1.73m2 and/or a 25% decrease on eGFR and 1.7% (n=7) of patients required RRT, 5.6% (n=23) of patients had CV events and 27.9% (n=114) of patients died. The incidence of MAKE was 60.9% (n=249), and MARCE was 36.6% (n=155). On a multivariate analysis, older age (adjusted HR 1.02 (95% CI: 1.01-1.04), p=0.008), cardiovascular disease (adjusted HR 2.22 (95% CI: 1.24-3.95), p=0.007), chronic kidney disease (adjusted HR 5.15 (95% CI: 2.22-11.93), p<0.001), and AKI (adjusted HR 1.76 (95% CI: 1.12-2.78), p=0.015) were independent predictors of MAKE. Older age (adjusted HR 1.06 (95% CI: 1.04-1.08), p<0.001) and neoplasia (adjusted HR 4.88 (95% CI: 2.37-10.04), p<0.001) were independent predictors of mortality.
Conclusion
AKI was independently associated with the risk of long-term need for dialysis and/or renal function decline and/or mortality after hospital discharge for COVID-19. Given the long-term impact of AKI, early detection of high-risk patients is essential to improve the outcomes of COVID-19 patients.