Predictors of Mortality in Patients with COVID-19 Infection-associated Acute Kidney Injury

Objective: To determine clinical characteristics, renal replacement therapy (RRT) requirements, and predictors of mortality in critically ill patients with COVID-19 associated AKI. Study Design: Descriptive study. Place and Duration of Study: Sakarya University Education and Training Hospital, Sakarya, Turkey, between April 1 and 30, 2020. Methodology: The study included 55 patients who were admitted with diagnosis of COVID-19, and whose illnesses showed a critical course that leads to AKI. The variables were studied as per objective. Results: During the follow-up, 43 out of 55 patients (78.2%) died and 12 (21.8%) were discharged with recovery. The mortality was higher in patients at stage 3 (88.9% mortality) compared to stage 2 (53.8% mortality) (p=0.014). In the nonsurvivor group, RDW (red cell distribution width) and albumin levels were lower at admission; whereas, the LDH levels and CRP/albumin ratios were higher. On regression analysis, low albumin level (OR: 12.793, p = 0.010), high LDH level (OR: 8.454, p = 0.026), and presence of stage 3 AKI (OR: 10.268, p = 0.020) were found as independent risk factors for mortality in COVID-19 patients, who developed AKI. Conclusion: In critically ill patients with COVID-19 pneumonia, who developed AKI, it was seen that the presence of low albumin, high LDH, and stage 3 AKI at the time of admission could be used as predictors of mortality. Moreover, it was shown for the first time that in these patients, the high CRP/albumin ratio and low RDW could be associated with mortality. Key Words: Acute kidney injury, Mortality, COVID-19.