Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.3389/fmed.2021.622577 http://hdl.handle.net/11449/205919 |
Resumo: | Renal involvement is frequent in COVID-19 (4–37%). This study evaluated the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients with COVID-19. Methodology: This study represents a prospective cohort in a public and tertiary university hospital in São Paulo, Brazil, during the first 90 days of the COVID-19 pandemic, with patients followed up until the clinical outcome (discharge or death). Results: There were 101 patients hospitalized with COVID-19, of which 51.9% were admitted to the intensive care unit (ICU). The overall AKI incidence was 50%; 36.8% had hematuria or proteinuria (66.6% of those with AKI), 10.2% had rhabdomyolysis, and mortality was 36.6%. Of the ICU patients, AKI occurred in 77.3% and the mortality was 65.4%. The mean time for the AKI diagnosis was 6 ± 2 days, and Kidney Disease Improving Global Outcomes (KDIGO) stage 3 AKI was the most frequent (58.9%). Acute renal replacement therapy was indicated in 61.5% of patients. The factors associated with AKI were obesity [odds ratio (OR) 1.98, 95% confidence interval (CI) 1.04–2.76, p < 0.05] and the APACHE II score (OR 1.97, 95% CI 1.08–2.64, p < 0.05). Mortality was higher in the elderly (OR 1.03, 95% CI 1.01–1.66, p < 0.05), in those with the highest APACHE II score (OR 1.08, 95% CI 1.02–1.98, p < 0.05), and in the presence of KDIGO stage 3 AKI (OR 1.11, 95% CI 1.05–2.57, p < 0.05). Conclusion: AKI associated with severe COVID-19 in this Brazilian cohort was more frequent than Chinese, European, and North American data, and the risk factors associated with its development were obesity and higher APACHE II scores. Mortality was high, mainly in elderly patients, in those with a more severe disease manifestation, and in those who developed KDIGO stage 3 AKI. |
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Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospitalacute kidney injuryCOVID-19dialysismortalityrisk factorsRenal involvement is frequent in COVID-19 (4–37%). This study evaluated the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients with COVID-19. Methodology: This study represents a prospective cohort in a public and tertiary university hospital in São Paulo, Brazil, during the first 90 days of the COVID-19 pandemic, with patients followed up until the clinical outcome (discharge or death). Results: There were 101 patients hospitalized with COVID-19, of which 51.9% were admitted to the intensive care unit (ICU). The overall AKI incidence was 50%; 36.8% had hematuria or proteinuria (66.6% of those with AKI), 10.2% had rhabdomyolysis, and mortality was 36.6%. Of the ICU patients, AKI occurred in 77.3% and the mortality was 65.4%. The mean time for the AKI diagnosis was 6 ± 2 days, and Kidney Disease Improving Global Outcomes (KDIGO) stage 3 AKI was the most frequent (58.9%). Acute renal replacement therapy was indicated in 61.5% of patients. The factors associated with AKI were obesity [odds ratio (OR) 1.98, 95% confidence interval (CI) 1.04–2.76, p < 0.05] and the APACHE II score (OR 1.97, 95% CI 1.08–2.64, p < 0.05). Mortality was higher in the elderly (OR 1.03, 95% CI 1.01–1.66, p < 0.05), in those with the highest APACHE II score (OR 1.08, 95% CI 1.02–1.98, p < 0.05), and in the presence of KDIGO stage 3 AKI (OR 1.11, 95% CI 1.05–2.57, p < 0.05). Conclusion: AKI associated with severe COVID-19 in this Brazilian cohort was more frequent than Chinese, European, and North American data, and the risk factors associated with its development were obesity and higher APACHE II scores. Mortality was high, mainly in elderly patients, in those with a more severe disease manifestation, and in those who developed KDIGO stage 3 AKI.Botucatu School of Medicine University São Paulo State-UNESPBotucatu School of Medicine University São Paulo State-UNESPUniversidade Estadual Paulista (Unesp)Zamoner, Welder [UNESP]Santos, Camilla Andrade da Silva [UNESP]Magalhães, Luís Eduardo [UNESP]Oliveira, Paula Gabriela Sousa de [UNESP]Balbi, André Luis [UNESP]Ponce, Daniela [UNESP]2021-06-25T10:23:32Z2021-06-25T10:23:32Z2021-02-09info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.3389/fmed.2021.622577Frontiers in Medicine, v. 8.2296-858Xhttp://hdl.handle.net/11449/20591910.3389/fmed.2021.6225772-s2.0-85101214751Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengFrontiers in Medicineinfo:eu-repo/semantics/openAccess2021-10-22T19:57:57Zoai:repositorio.unesp.br:11449/205919Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T19:12:06.246858Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital |
title |
Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital |
spellingShingle |
Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital Zamoner, Welder [UNESP] acute kidney injury COVID-19 dialysis mortality risk factors |
title_short |
Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital |
title_full |
Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital |
title_fullStr |
Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital |
title_full_unstemmed |
Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital |
title_sort |
Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital |
author |
Zamoner, Welder [UNESP] |
author_facet |
Zamoner, Welder [UNESP] Santos, Camilla Andrade da Silva [UNESP] Magalhães, Luís Eduardo [UNESP] Oliveira, Paula Gabriela Sousa de [UNESP] Balbi, André Luis [UNESP] Ponce, Daniela [UNESP] |
author_role |
author |
author2 |
Santos, Camilla Andrade da Silva [UNESP] Magalhães, Luís Eduardo [UNESP] Oliveira, Paula Gabriela Sousa de [UNESP] Balbi, André Luis [UNESP] Ponce, Daniela [UNESP] |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
Zamoner, Welder [UNESP] Santos, Camilla Andrade da Silva [UNESP] Magalhães, Luís Eduardo [UNESP] Oliveira, Paula Gabriela Sousa de [UNESP] Balbi, André Luis [UNESP] Ponce, Daniela [UNESP] |
dc.subject.por.fl_str_mv |
acute kidney injury COVID-19 dialysis mortality risk factors |
topic |
acute kidney injury COVID-19 dialysis mortality risk factors |
description |
Renal involvement is frequent in COVID-19 (4–37%). This study evaluated the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients with COVID-19. Methodology: This study represents a prospective cohort in a public and tertiary university hospital in São Paulo, Brazil, during the first 90 days of the COVID-19 pandemic, with patients followed up until the clinical outcome (discharge or death). Results: There were 101 patients hospitalized with COVID-19, of which 51.9% were admitted to the intensive care unit (ICU). The overall AKI incidence was 50%; 36.8% had hematuria or proteinuria (66.6% of those with AKI), 10.2% had rhabdomyolysis, and mortality was 36.6%. Of the ICU patients, AKI occurred in 77.3% and the mortality was 65.4%. The mean time for the AKI diagnosis was 6 ± 2 days, and Kidney Disease Improving Global Outcomes (KDIGO) stage 3 AKI was the most frequent (58.9%). Acute renal replacement therapy was indicated in 61.5% of patients. The factors associated with AKI were obesity [odds ratio (OR) 1.98, 95% confidence interval (CI) 1.04–2.76, p < 0.05] and the APACHE II score (OR 1.97, 95% CI 1.08–2.64, p < 0.05). Mortality was higher in the elderly (OR 1.03, 95% CI 1.01–1.66, p < 0.05), in those with the highest APACHE II score (OR 1.08, 95% CI 1.02–1.98, p < 0.05), and in the presence of KDIGO stage 3 AKI (OR 1.11, 95% CI 1.05–2.57, p < 0.05). Conclusion: AKI associated with severe COVID-19 in this Brazilian cohort was more frequent than Chinese, European, and North American data, and the risk factors associated with its development were obesity and higher APACHE II scores. Mortality was high, mainly in elderly patients, in those with a more severe disease manifestation, and in those who developed KDIGO stage 3 AKI. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-25T10:23:32Z 2021-06-25T10:23:32Z 2021-02-09 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.3389/fmed.2021.622577 Frontiers in Medicine, v. 8. 2296-858X http://hdl.handle.net/11449/205919 10.3389/fmed.2021.622577 2-s2.0-85101214751 |
url |
http://dx.doi.org/10.3389/fmed.2021.622577 http://hdl.handle.net/11449/205919 |
identifier_str_mv |
Frontiers in Medicine, v. 8. 2296-858X 10.3389/fmed.2021.622577 2-s2.0-85101214751 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Frontiers in Medicine |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808129032830582784 |