Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology
Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI. In this multicenter retrospective obser...
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| Veröffentlicht in: | PloS one 2021-08, Vol.16 (8), p.e0256023 |
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| creator | Arikan, Hakki Ozturk, Savas Tokgoz, Bulent Dursun, Belda Seyahi, Nurhan Trabulus, Sinan Islam, Mahmud Ayar, Yavuz Gorgulu, Numan Karadag, Serhat Gok, Mahmut Akcali, Esra Bora, Feyza Aydın, Zeki Altun, Eda Ahbap, Elbis Polat, Mehmet Soypacacı, Zeki Oguz, Ebru Gok Koyuncu, Sumeyra Colak, Hulya Sahin, İdris Dolarslan, Murside Esra Helvacı, Ozant Kurultak, Ilhan Eren, Zehra Dheir, Hamad Ogutmen, Melike Betul Taymez, Dilek Guven Genek, Dilek Gibyeli Ozkurt, Sultan Bakır, Elif Ari Yuksel, Enver Sahutoglu, Tuncay Oto, Ozgur Akin Boz, Gulsah Sengul, Erkan Kara, Ekrem Tuglular, Serhan |
| description | Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI.
In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients.
The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality.
Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue i |
| doi_str_mv | 10.1371/journal.pone.0256023 |
| format | Article |
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In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients.
The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality.
Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0256023</identifier><identifier>PMID: 34375366</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acute Kidney Injury - etiology ; Acute Kidney Injury - pathology ; Age ; Aged ; Biology and Life Sciences ; Care and treatment ; Cerebrovascular diseases ; Chronic kidney failure ; Clinical outcomes ; Comorbidity ; Confidence intervals ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - mortality ; COVID-19 - pathology ; COVID-19 - virology ; Creatinine ; Cytokines ; Diabetes mellitus ; Dialysis ; Education ; End-stage renal disease ; Female ; Funding ; Gender ; Health risks ; Health sciences ; Hemodialysis ; Hospital Mortality ; Hospital patients ; Hospitalization ; Hospitals ; Humans ; Hypertension ; Intensive care ; Intensive Care Units ; Internal medicine ; Kidney diseases ; Kidney transplantation ; Kidneys ; L-Lactate dehydrogenase ; L-Lactate Dehydrogenase - blood ; Lactate dehydrogenase ; Lactic acid ; Male ; Males ; Medical prognosis ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Nephrology ; Observational studies ; Patient outcomes ; Patients ; Proportional Hazards Models ; Regression analysis ; Retrospective Studies ; Risk analysis ; Risk Factors ; SARS-CoV-2 - isolation & purification ; Severe acute respiratory syndrome coronavirus 2 ; Severity of Illness Index ; Sex Factors ; Software ; Statistical analysis ; Supervision ; Turkey ; University faculty ; Viral diseases</subject><ispartof>PloS one, 2021-08, Vol.16 (8), p.e0256023</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Arikan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Arikan et al 2021 Arikan et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-ed26569e91355cdbb1a1118781e43097f8129bdeda0f652d2002208022aa29653</citedby><cites>FETCH-LOGICAL-c692t-ed26569e91355cdbb1a1118781e43097f8129bdeda0f652d2002208022aa29653</cites><orcidid>0000-0003-4607-9220 ; 0000-0002-1382-2439 ; 0000-0003-1284-916X ; 0000-0003-0946-0823 ; 0000-0001-6195-1932</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354466/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354466/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34375366$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Reboldi, Gianpaolo</contributor><creatorcontrib>Arikan, Hakki</creatorcontrib><creatorcontrib>Ozturk, Savas</creatorcontrib><creatorcontrib>Tokgoz, Bulent</creatorcontrib><creatorcontrib>Dursun, Belda</creatorcontrib><creatorcontrib>Seyahi, Nurhan</creatorcontrib><creatorcontrib>Trabulus, Sinan</creatorcontrib><creatorcontrib>Islam, Mahmud</creatorcontrib><creatorcontrib>Ayar, Yavuz</creatorcontrib><creatorcontrib>Gorgulu, Numan</creatorcontrib><creatorcontrib>Karadag, Serhat</creatorcontrib><creatorcontrib>Gok, Mahmut</creatorcontrib><creatorcontrib>Akcali, Esra</creatorcontrib><creatorcontrib>Bora, Feyza</creatorcontrib><creatorcontrib>Aydın, Zeki</creatorcontrib><creatorcontrib>Altun, Eda</creatorcontrib><creatorcontrib>Ahbap, Elbis</creatorcontrib><creatorcontrib>Polat, Mehmet</creatorcontrib><creatorcontrib>Soypacacı, Zeki</creatorcontrib><creatorcontrib>Oguz, Ebru Gok</creatorcontrib><creatorcontrib>Koyuncu, Sumeyra</creatorcontrib><creatorcontrib>Colak, Hulya</creatorcontrib><creatorcontrib>Sahin, İdris</creatorcontrib><creatorcontrib>Dolarslan, Murside Esra</creatorcontrib><creatorcontrib>Helvacı, Ozant</creatorcontrib><creatorcontrib>Kurultak, Ilhan</creatorcontrib><creatorcontrib>Eren, Zehra</creatorcontrib><creatorcontrib>Dheir, Hamad</creatorcontrib><creatorcontrib>Ogutmen, Melike Betul</creatorcontrib><creatorcontrib>Taymez, Dilek Guven</creatorcontrib><creatorcontrib>Genek, Dilek Gibyeli</creatorcontrib><creatorcontrib>Ozkurt, Sultan</creatorcontrib><creatorcontrib>Bakır, Elif Ari</creatorcontrib><creatorcontrib>Yuksel, Enver</creatorcontrib><creatorcontrib>Sahutoglu, Tuncay</creatorcontrib><creatorcontrib>Oto, Ozgur Akin</creatorcontrib><creatorcontrib>Boz, Gulsah</creatorcontrib><creatorcontrib>Sengul, Erkan</creatorcontrib><creatorcontrib>Kara, Ekrem</creatorcontrib><creatorcontrib>Tuglular, Serhan</creatorcontrib><title>Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI.
In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients.
The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality.
Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.</description><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - pathology</subject><subject>Age</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Cerebrovascular diseases</subject><subject>Chronic kidney failure</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Confidence intervals</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - mortality</subject><subject>COVID-19 - pathology</subject><subject>COVID-19 - virology</subject><subject>Creatinine</subject><subject>Cytokines</subject><subject>Diabetes mellitus</subject><subject>Dialysis</subject><subject>Education</subject><subject>End-stage renal disease</subject><subject>Female</subject><subject>Funding</subject><subject>Gender</subject><subject>Health risks</subject><subject>Health sciences</subject><subject>Hemodialysis</subject><subject>Hospital Mortality</subject><subject>Hospital patients</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Internal medicine</subject><subject>Kidney diseases</subject><subject>Kidney transplantation</subject><subject>Kidneys</subject><subject>L-Lactate dehydrogenase</subject><subject>L-Lactate Dehydrogenase - blood</subject><subject>Lactate dehydrogenase</subject><subject>Lactic acid</subject><subject>Male</subject><subject>Males</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nephrology</subject><subject>Observational studies</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Severity of Illness Index</subject><subject>Sex Factors</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>Supervision</subject><subject>Turkey</subject><subject>University faculty</subject><subject>Viral 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and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology</title><author>Arikan, Hakki ; Ozturk, Savas ; Tokgoz, Bulent ; Dursun, Belda ; Seyahi, Nurhan ; Trabulus, Sinan ; Islam, Mahmud ; Ayar, Yavuz ; Gorgulu, Numan ; Karadag, Serhat ; Gok, Mahmut ; Akcali, Esra ; Bora, Feyza ; Aydın, Zeki ; Altun, Eda ; Ahbap, Elbis ; Polat, Mehmet ; Soypacacı, Zeki ; Oguz, Ebru Gok ; Koyuncu, Sumeyra ; Colak, Hulya ; Sahin, İdris ; Dolarslan, Murside Esra ; Helvacı, Ozant ; Kurultak, Ilhan ; Eren, Zehra ; Dheir, Hamad ; Ogutmen, Melike Betul ; Taymez, Dilek Guven ; Genek, Dilek Gibyeli ; Ozkurt, Sultan ; Bakır, Elif Ari ; Yuksel, Enver ; Sahutoglu, Tuncay ; Oto, Ozgur Akin ; Boz, Gulsah ; Sengul, Erkan ; Kara, Ekrem ; Tuglular, Serhan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-ed26569e91355cdbb1a1118781e43097f8129bdeda0f652d2002208022aa29653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - pathology</topic><topic>Age</topic><topic>Aged</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Cerebrovascular diseases</topic><topic>Chronic kidney failure</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Confidence intervals</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - mortality</topic><topic>COVID-19 - pathology</topic><topic>COVID-19 - virology</topic><topic>Creatinine</topic><topic>Cytokines</topic><topic>Diabetes mellitus</topic><topic>Dialysis</topic><topic>Education</topic><topic>End-stage renal 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Sultan</creatorcontrib><creatorcontrib>Bakır, Elif Ari</creatorcontrib><creatorcontrib>Yuksel, Enver</creatorcontrib><creatorcontrib>Sahutoglu, Tuncay</creatorcontrib><creatorcontrib>Oto, Ozgur Akin</creatorcontrib><creatorcontrib>Boz, Gulsah</creatorcontrib><creatorcontrib>Sengul, Erkan</creatorcontrib><creatorcontrib>Kara, Ekrem</creatorcontrib><creatorcontrib>Tuglular, Serhan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arikan, Hakki</au><au>Ozturk, Savas</au><au>Tokgoz, Bulent</au><au>Dursun, Belda</au><au>Seyahi, Nurhan</au><au>Trabulus, Sinan</au><au>Islam, Mahmud</au><au>Ayar, Yavuz</au><au>Gorgulu, Numan</au><au>Karadag, Serhat</au><au>Gok, Mahmut</au><au>Akcali, Esra</au><au>Bora, Feyza</au><au>Aydın, Zeki</au><au>Altun, Eda</au><au>Ahbap, Elbis</au><au>Polat, Mehmet</au><au>Soypacacı, Zeki</au><au>Oguz, Ebru Gok</au><au>Koyuncu, Sumeyra</au><au>Colak, Hulya</au><au>Sahin, İdris</au><au>Dolarslan, Murside Esra</au><au>Helvacı, Ozant</au><au>Kurultak, Ilhan</au><au>Eren, Zehra</au><au>Dheir, Hamad</au><au>Ogutmen, Melike Betul</au><au>Taymez, Dilek Guven</au><au>Genek, Dilek Gibyeli</au><au>Ozkurt, Sultan</au><au>Bakır, Elif Ari</au><au>Yuksel, Enver</au><au>Sahutoglu, Tuncay</au><au>Oto, Ozgur Akin</au><au>Boz, Gulsah</au><au>Sengul, Erkan</au><au>Kara, Ekrem</au><au>Tuglular, Serhan</au><au>Reboldi, Gianpaolo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-08-10</date><risdate>2021</risdate><volume>16</volume><issue>8</issue><spage>e0256023</spage><pages>e0256023-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI.
In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients.
The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality.
Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34375366</pmid><doi>10.1371/journal.pone.0256023</doi><tpages>e0256023</tpages><orcidid>https://orcid.org/0000-0003-4607-9220</orcidid><orcidid>https://orcid.org/0000-0002-1382-2439</orcidid><orcidid>https://orcid.org/0000-0003-1284-916X</orcidid><orcidid>https://orcid.org/0000-0003-0946-0823</orcidid><orcidid>https://orcid.org/0000-0001-6195-1932</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-08, Vol.16 (8), p.e0256023 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2560041019 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acute Kidney Injury - etiology Acute Kidney Injury - pathology Age Aged Biology and Life Sciences Care and treatment Cerebrovascular diseases Chronic kidney failure Clinical outcomes Comorbidity Confidence intervals Coronaviruses COVID-19 COVID-19 - complications COVID-19 - mortality COVID-19 - pathology COVID-19 - virology Creatinine Cytokines Diabetes mellitus Dialysis Education End-stage renal disease Female Funding Gender Health risks Health sciences Hemodialysis Hospital Mortality Hospital patients Hospitalization Hospitals Humans Hypertension Intensive care Intensive Care Units Internal medicine Kidney diseases Kidney transplantation Kidneys L-Lactate dehydrogenase L-Lactate Dehydrogenase - blood Lactate dehydrogenase Lactic acid Male Males Medical prognosis Medicine Medicine and Health Sciences Middle Aged Mortality Nephrology Observational studies Patient outcomes Patients Proportional Hazards Models Regression analysis Retrospective Studies Risk analysis Risk Factors SARS-CoV-2 - isolation & purification Severe acute respiratory syndrome coronavirus 2 Severity of Illness Index Sex Factors Software Statistical analysis Supervision Turkey University faculty Viral diseases |
| title | Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology |
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