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Acute and chronic kidney disease and risk of hospital mortality during COVID-19 pandemic waves in the pre-vaccination era.
Portolés, José; López-Sánchez, Paula; Martin-Rodríguez, Leyre; Serrano-Salazar, María Luisa; Valdenebro-Recio, Maria; Ramos, Antonio; Malo, Rosa María; Zalamea, Felipe; Martin-Giner, Juan Manuel; Marques, María; Ortiz, Alberto.
Afiliación
  • Portolés J; Nephrology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain.
  • López-Sánchez P; Research Network REDInREN 016/009/009 Instituto Salud Carlos III, Madrid, Spain.
  • Martin-Rodríguez L; BIGSEN-Big Data, Inteligencia Artificial-S.E.N.
  • Serrano-Salazar ML; Nephrology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain.
  • Valdenebro-Recio M; Nephrology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain.
  • Ramos A; Research Network REDInREN 016/009/009 Instituto Salud Carlos III, Madrid, Spain.
  • Malo RM; BIGSEN-Big Data, Inteligencia Artificial-S.E.N.
  • Zalamea F; Nephrology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain.
  • Martin-Giner JM; Research Network REDInREN 016/009/009 Instituto Salud Carlos III, Madrid, Spain.
  • Marques M; Nephrology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain.
  • Ortiz A; Research Network REDInREN 016/009/009 Instituto Salud Carlos III, Madrid, Spain.
Clin Kidney J ; 16(2): 374-383, 2023 Feb.
Article en En | MEDLINE | ID: mdl-36751624
Background: Chronic kidney disease (CKD) is a risk factor for death from coronavirus disease 2019 (COVID-19), and COVID-19 may cause acute kidney injury (AKI) which also influences outcomes. There is little information on the independent contribution of CKD and AKI to the risk of death in COVID-19 on different waves, as CKD is a key risk factor for AKI. Methods: We have studied the epidemiology of CKD and AKI in 2878 patients hospitalized for COVID-19 and their independent association with in-hospital mortality in the two largest pre-vaccination COVID-19 waves in Madrid, Spain. Hospitalized COVID-19 patients were grouped into four mutually exclusive categories: previous-CKD, community-acquired AKI (CA-AKI), hospital-acquired AKI (HA-AKI) and normal renal function throughout hospitalization. Results: Pre-existent or acquired kidney involvement was observed in 35.5% and 36.8% of COVID-19 patients in the 1st and 3rd waves, respectively. Overall, 13.9% of patients with normal kidney function on arrival developed HA-AKI. In the 3rd wave, CA-AKI was more common than in the 1st wave. Overall, 9%-20% of CKD cases and 22%-40% of AKI cases remained undiagnosed in the discharge report. CKD, CA-AKI and HA-AKI were independently associated with risk of death in multivariate analysis, with HA-AKI, which was usually mild, being the most relevant independent risk factor for in-hospital mortality. A model including kidney involvement category, age, Charlson index, admission lactate dehydrogenase and lymphocytes predicted death with a receiver operating characteristic area under the curve of 0.898. Conclusion: In conclusion, CKD and AKI were common in pre-vaccination waves among hospitalized COVID-19 patients and were independent risk factors for death, even when AKI was mild to moderate, and despite improvements in treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Clin Kidney J Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Clin Kidney J Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido