Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2
Background. Acute kidney injury (AKI) is associated with poor outcomes in patients infected with SARS-CoV-2. Sepsis, direct injury to kidney cells by the virus, and severe systemic inflammation are mechanisms implicated in its development. We investigated the association between inflammatory markers...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | International Journal of Clinical Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/1363994 |
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| author | Jorge Andrade Sierra Claudia Delgado Astorga Miriam Gabriela Nava Vargas Enrique Rojas Campos Kevin Javier Arrelano Arteaga Karla Hernández Morales Carlos A. Andrade Castellanos Antonio de Jesús Andrade-Ortega Luis Gerardo González Correa |
| author_facet | Jorge Andrade Sierra Claudia Delgado Astorga Miriam Gabriela Nava Vargas Enrique Rojas Campos Kevin Javier Arrelano Arteaga Karla Hernández Morales Carlos A. Andrade Castellanos Antonio de Jesús Andrade-Ortega Luis Gerardo González Correa |
| author_sort | Jorge Andrade Sierra |
| collection | DOAJ |
| description | Background. Acute kidney injury (AKI) is associated with poor outcomes in patients infected with SARS-CoV-2. Sepsis, direct injury to kidney cells by the virus, and severe systemic inflammation are mechanisms implicated in its development. We investigated the association between inflammatory markers (C-reactive protein, procalcitonin, D-dimer, lactate dehydrogenase, and ferritin) in patients infected with SARS-CoV-2 and the development of AKI. Methods. A prospective cohort study performed at the Civil Hospital (Dr. Juan I. Menchaca) Guadalajara, Mexico, included patients aged >18 years with a diagnosis of SARS-CoV-2 pneumonia confirmed by RT-PCR and who did or did not present with AKI (KDIGO) while hospitalized. Biomarkers of inflammation were recorded, and kidney function was estimated using the CKD-EPI formula. Results. 291 patients were included (68% males; average age, 57 years). The incidence of AKI was 40.5% (118 patients); 21% developed stage 1 AKI, 6% developed stage 2 AKI, and 14% developed stage 3 AKI. The development of AKI was associated with higher phosphate (p=0.002) (RR 1.39, CI 95% 1.13–1.72), high procalcitonin levels at hospital admission (p=0.005) (RR 2.09, CI 95% 1.26–3.50), and high APACHE scores (p=0.011) (RR 2.0, CI 95% 1.17–3.40). The survival analysis free of AKI according to procalcitonin levels and APACHE scores demonstrated a lower survival in patients with procalcitonin >0.5 ng/ml (p=0.001) and APACHE >15 points (p=0.004). Conclusions. Phosphate, high procalcitonin levels, and APACHE levels >15 were predictors of AKI development in patients hospitalized with COVID-19. |
| format | Article |
| id | doaj-art-72d0f275caee4bfe8b7ea7eee47f39d4 |
| institution | Kabale University |
| issn | 1742-1241 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Clinical Practice |
| spelling | doaj-art-72d0f275caee4bfe8b7ea7eee47f39d42025-02-03T01:21:04ZengWileyInternational Journal of Clinical Practice1742-12412022-01-01202210.1155/2022/1363994Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2Jorge Andrade Sierra0Claudia Delgado Astorga1Miriam Gabriela Nava Vargas2Enrique Rojas Campos3Kevin Javier Arrelano Arteaga4Karla Hernández Morales5Carlos A. Andrade Castellanos6Antonio de Jesús Andrade-Ortega7Luis Gerardo González Correa8Department of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineMedical Research Unit in Kidney DiseasesDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of PhysiologyMedical Research Unit in Kidney DiseasesBackground. Acute kidney injury (AKI) is associated with poor outcomes in patients infected with SARS-CoV-2. Sepsis, direct injury to kidney cells by the virus, and severe systemic inflammation are mechanisms implicated in its development. We investigated the association between inflammatory markers (C-reactive protein, procalcitonin, D-dimer, lactate dehydrogenase, and ferritin) in patients infected with SARS-CoV-2 and the development of AKI. Methods. A prospective cohort study performed at the Civil Hospital (Dr. Juan I. Menchaca) Guadalajara, Mexico, included patients aged >18 years with a diagnosis of SARS-CoV-2 pneumonia confirmed by RT-PCR and who did or did not present with AKI (KDIGO) while hospitalized. Biomarkers of inflammation were recorded, and kidney function was estimated using the CKD-EPI formula. Results. 291 patients were included (68% males; average age, 57 years). The incidence of AKI was 40.5% (118 patients); 21% developed stage 1 AKI, 6% developed stage 2 AKI, and 14% developed stage 3 AKI. The development of AKI was associated with higher phosphate (p=0.002) (RR 1.39, CI 95% 1.13–1.72), high procalcitonin levels at hospital admission (p=0.005) (RR 2.09, CI 95% 1.26–3.50), and high APACHE scores (p=0.011) (RR 2.0, CI 95% 1.17–3.40). The survival analysis free of AKI according to procalcitonin levels and APACHE scores demonstrated a lower survival in patients with procalcitonin >0.5 ng/ml (p=0.001) and APACHE >15 points (p=0.004). Conclusions. Phosphate, high procalcitonin levels, and APACHE levels >15 were predictors of AKI development in patients hospitalized with COVID-19.http://dx.doi.org/10.1155/2022/1363994 |
| spellingShingle | Jorge Andrade Sierra Claudia Delgado Astorga Miriam Gabriela Nava Vargas Enrique Rojas Campos Kevin Javier Arrelano Arteaga Karla Hernández Morales Carlos A. Andrade Castellanos Antonio de Jesús Andrade-Ortega Luis Gerardo González Correa Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2 International Journal of Clinical Practice |
| title | Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2 |
| title_full | Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2 |
| title_fullStr | Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2 |
| title_full_unstemmed | Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2 |
| title_short | Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2 |
| title_sort | procalcitonin and high apache acute physiological and chronic health evaluation level are associated with the course of acute kidney injury in patients with sars cov 2 |
| url | http://dx.doi.org/10.1155/2022/1363994 |
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