Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/47658
Title: Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology
Authors: Arıkan, Hakkı
Özturk, Savaş
Tokgöz, Bülent
Dursun, Belda
Seyahi, Nurhan
Trabulus, Sinan
İslam, Mahmud
Ayar, Yavuz
Görgülü, Numan
Gök, Mahmut
Akçalı, Esra
Bora, Feyza
Aydın, Zeki
Altun, Eda
Ahbap, Elbis
Polat, Mehmet
Soypacacı, Zeki
Gök Oğuz, Ebru
Koyuncu, Sümeyra
Çolak, Hülya
Şahin, İdris
Dolarslan, Mürşide Esra
Helvacı, Özant
Kurultak, İlhan
Eren, Zehra
Dheir, Hamad
Öğutmen, Melike Betül
Güven Taymez, Dilek
Gibyeli Genek, Dilek
Özkurt, Sultan
Arı Bakır, Elif
Yüksel, Enver
Sahutoğlu, Tuncay
Oto, Özgur Akın
Boz, Gülşah
Şengül, Erkan
Kara, Ekrem
Tuğlular, Serhan
Keywords: lactate dehydrogenase
lactate dehydrogenase
acute kidney failure
adult
aged
Article
causal attribution
chronic kidney failure
cohort analysis
comorbidity
coronavirus disease 2019
diabetes mellitus
disease association
disease severity
female
hazard ratio
hospital discharge
hospital patient
human
hypertension
in-hospital mortality
lactate dehydrogenase blood level
major clinical study
male
mortality rate
observational study
outcome assessment
retrospective study
sex ratio
acute kidney failure
blood
clinical trial
complication
hospital mortality
hospitalization
intensive care unit
isolation and purification
middle aged
mortality
multicenter study
pathology
proportional hazards model
risk factor
severity of illness index
sex factor
turkey (bird)
virology
Acute Kidney Injury
Aged
Comorbidity
COVID-19
Female
Hospital Mortality
Hospitalization
Humans
Intensive Care Units
L-Lactate Dehydrogenase
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Risk Factors
SARS-CoV-2
Severity of Illness Index
Sex Factors
Turkey
Publisher: Public Library of Science
Abstract: Background 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. Methods 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. Results 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. Conclusions 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. © 2021 Arikan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
URI: https://doi.org/10.1371/journal.pone.0256023
https://hdl.handle.net/11499/47658
ISSN: 1932-6203
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu

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