Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact [version 3; peer review: 2 approved]
Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mainly affects the respiratory tract, but different organs may be involved including the kidney. Data on acute kidney injury (AKI) in critical forms of coronavirus disease 2019 (COVID-19) are scarce. We aimed to assess the incid...
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F1000 Research Ltd
2025-01-01
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| author | Ghadhoune Hatem Yosra Yahia Olfa Hammami Hend Allouche Insaf Trabelsi Jihene Guissouma Hana Ben Ali |
| author_facet | Ghadhoune Hatem Yosra Yahia Olfa Hammami Hend Allouche Insaf Trabelsi Jihene Guissouma Hana Ben Ali |
| author_sort | Ghadhoune Hatem |
| collection | DOAJ |
| description | Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mainly affects the respiratory tract, but different organs may be involved including the kidney. Data on acute kidney injury (AKI) in critical forms of coronavirus disease 2019 (COVID-19) are scarce. We aimed to assess the incidence, risk factors and prognostic impact of AKI complicating critical forms of COVID-19. Methods A retrospective descriptive case/control monocentric study conducted in a medical intensive care unit of a tertiary teaching hospital over a period of 18 months. Results We enrolled 144 patients, with a mean age of 58±13 years old and a male predominance (sex-ratio: 1.25). Forty-one (28%) developed AKI within a median of 4 days (Q1: 3, Q3: 8.5) after hospitalization. It was staged KDIGO class 3, in about half of the cases. Thirteen patients underwent renal replacement therapy and renal function improved in seven cases. Diabetes (OR: 6.07; 95% CI: (1,30-28,4); p: 0.022), nephrotoxic antibiotics (OR: 21; 95% CI: (3,2-146); p: 0.002), and shock (OR: 12.21; 95% CI: (2.87-51.85); p: 0.031,) were the three independent risk factors of AKI onset. Mortality was significantly higher in AKI group (HR:12; 95% CI: (5.81-18.18); p:0.041) but AKI didn’t appear to be an independent risk factor of poor outcome. In fact, age > 53 years (p: 0.018), septic shock complicating hospital acquired infection (p: 0.003) and mechanical ventilation (p<0.001) were the three prognostic factors in multivariate analysis. Conclusions The incidence of AKI was high in this study and associated to an increased mortality. Diabetes, use of nephrotoxic antibiotics and shock contributed significantly to its occurrence. This underlines the importance of rationalizing antibiotic prescription and providing adequate management of patients with hemodynamic instability in order to prevent consequent AKI. |
| format | Article |
| id | doaj-art-38100c7daf4f4cf6937ecd4c853edd87 |
| institution | Kabale University |
| issn | 2046-1402 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | F1000 Research Ltd |
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| spelling | doaj-art-38100c7daf4f4cf6937ecd4c853edd872025-01-21T01:00:00ZengF1000 Research LtdF1000Research2046-14022025-01-0113176287Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact [version 3; peer review: 2 approved]Ghadhoune Hatem0Yosra Yahia1Olfa Hammami2https://orcid.org/0000-0002-0834-9587Hend Allouche3https://orcid.org/0000-0003-2090-9687Insaf Trabelsi4Jihene Guissouma5https://orcid.org/0000-0002-7852-9030Hana Ben Ali6Medical intensive care unit of Bizerte University Hospital, Bizerte, 7021, TunisiaUniversity of Tunis El Manar Faculty of medicine of Tunis, Tunis, 1007, TunisiaUniversity of Tunis El Manar Faculty of medicine of Tunis, Tunis, 1007, TunisiaMedical intensive care unit of Bizerte University Hospital, Bizerte, 7021, TunisiaMedical intensive care unit of Bizerte University Hospital, Bizerte, 7021, TunisiaMedical intensive care unit of Bizerte University Hospital, Bizerte, 7021, TunisiaMedical intensive care unit of Bizerte University Hospital, Bizerte, 7021, TunisiaBackground Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mainly affects the respiratory tract, but different organs may be involved including the kidney. Data on acute kidney injury (AKI) in critical forms of coronavirus disease 2019 (COVID-19) are scarce. We aimed to assess the incidence, risk factors and prognostic impact of AKI complicating critical forms of COVID-19. Methods A retrospective descriptive case/control monocentric study conducted in a medical intensive care unit of a tertiary teaching hospital over a period of 18 months. Results We enrolled 144 patients, with a mean age of 58±13 years old and a male predominance (sex-ratio: 1.25). Forty-one (28%) developed AKI within a median of 4 days (Q1: 3, Q3: 8.5) after hospitalization. It was staged KDIGO class 3, in about half of the cases. Thirteen patients underwent renal replacement therapy and renal function improved in seven cases. Diabetes (OR: 6.07; 95% CI: (1,30-28,4); p: 0.022), nephrotoxic antibiotics (OR: 21; 95% CI: (3,2-146); p: 0.002), and shock (OR: 12.21; 95% CI: (2.87-51.85); p: 0.031,) were the three independent risk factors of AKI onset. Mortality was significantly higher in AKI group (HR:12; 95% CI: (5.81-18.18); p:0.041) but AKI didn’t appear to be an independent risk factor of poor outcome. In fact, age > 53 years (p: 0.018), septic shock complicating hospital acquired infection (p: 0.003) and mechanical ventilation (p<0.001) were the three prognostic factors in multivariate analysis. Conclusions The incidence of AKI was high in this study and associated to an increased mortality. Diabetes, use of nephrotoxic antibiotics and shock contributed significantly to its occurrence. This underlines the importance of rationalizing antibiotic prescription and providing adequate management of patients with hemodynamic instability in order to prevent consequent AKI.https://f1000research.com/articles/13-497/v3acute kidney injury coronavirus disease 2019 mortality risk factors prognosis.eng |
| spellingShingle | Ghadhoune Hatem Yosra Yahia Olfa Hammami Hend Allouche Insaf Trabelsi Jihene Guissouma Hana Ben Ali Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact [version 3; peer review: 2 approved] F1000Research acute kidney injury coronavirus disease 2019 mortality risk factors prognosis. eng |
| title | Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact [version 3; peer review: 2 approved] |
| title_full | Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact [version 3; peer review: 2 approved] |
| title_fullStr | Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact [version 3; peer review: 2 approved] |
| title_full_unstemmed | Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact [version 3; peer review: 2 approved] |
| title_short | Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact [version 3; peer review: 2 approved] |
| title_sort | acute kidney injury complicating critical forms of covid 19 risk factors and prognostic impact version 3 peer review 2 approved |
| topic | acute kidney injury coronavirus disease 2019 mortality risk factors prognosis. eng |
| url | https://f1000research.com/articles/13-497/v3 |
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