American Society of Nephrology (ASN)

Kidney Damage From COVID-19 Linked to Higher Risk of In-Hospital Death

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  • In an analysis of patients hospitalized with COVID-19, kidney damage associated with the infectious disease was linked with a higher risk of dying during hospitalization.

Newswise — Washington, DC (September 22, 2020) — Many individuals who develop COVID-19 experience kidney damage, or acute kidney injury (AKI). Investigators recently evaluated the incidence, risk factors, and prognosis of AKI in adults with COVID-19. Their findings appear in an upcoming issue of CJASN.

The study was conducted in Tongji hospital in Wuhan, China, which was assigned responsibility for the treatment of severe COVID-19 cases by the local government. Investigators led by Gang Xu, PhD and Shuwang Ge, MD analyzed information pertaining to 1,392 patients who tested positive for the virus that causes COVID-19.

The team found that, in patients with COVID-19, AKI is uncommon but is linked with a high risk of in-hospital mortality. Seven percent of patients developed AKI during hospitalization, many within 7 days after admission. The in-hospital mortality rate was 10% in patients without AKI vs.72% in patients with AKI. After adjusting for potential confounding factors, AKI was associated with a 5-times higher odds of dying while in the hospital. Also, the risk of death was higher with greater severity of AKI. 

Factors associated with a higher risk of AKI included severe COVID-19 disease, high blood levels of creatinine (an indicator of kidney dysfunction), low blood levels of certain immune cells, and high blood levels of a protein fragment indicative of elevated blood clot formation and breakdown.

“Prior to this study, there was limited information concerning epidemiological characteristics and outcomes associated with AKI in patients with COVID-19,” said Dr. Xu. “Our results indicate that AKI is strongly associated with mortality, and that careful monitoring of AKI is necessary early in the course of infection.”

An accompanying editorial notes that additional studies are needed to investigate why AKI is linked with such a high risk of premature death in patients with COVID-19.

Study co-authors include Yichun Cheng, MD, Ran Luo, MD, Xu Wang, MD, Kun Wang, MD, Meng Zhang, PhD, Zhixiang Wang, MD, Lei Dong, MD, Junhua Li, PhD, and Ying Yao, PhD.

Disclosures: The authors reported no financial disclosures.

The article, titled “The Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Adult Patients with Coronavirus Disease 2019,” will appear online at http://cjasn.asnjournals.org/ on September 22, 2020, doi: 10.2215/CJN.04650420.

The editorial, titled “COVID 19-Associated AKI: An Evolving Picture,” will appear online at http://cjasn.asnjournals.org/ on September 22, 2020, doi: 10.2215/CJN.13600820.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 21,000 members representing 131 countries. For more information, visit www.asn-online.org.

 

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