The Incidence, Risk Factors and Prognosis of Acute Kidney Injury in Severe and Critically Ill Patients with COVID-19 in ICU of Eka Kotebe Hospital, Addis Ababa Ethiopia: A Retrospective Chart Reviews.
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Date
2021-12
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Addis Abeba University
Abstract
Abstract
Background-The incidence, clinical characteristics and outcomes of acute kidney injury (AKI)
in patients with COVID-19 admitted to intensive care unit and its association with mortality and
disease severity.
Objective-To determine the incidence, risk factors, clinical characteristics and outcomes of AKI
in a cohort of patients with COVID-19 admitted to Eka Kotebe Intensive Care Unit (ICU), and
its association with in-hospital mortality(survival), dialysis requirement, increased need of
mechanical ventilation, disease severity and renal status at discharge.
Methods- It’s a single centered cohort study from a registry of patients with COVID-19. A total
of 174 patients were admitted to medical ICU with confirmed COVID-19 between from 1st
October 2020 to 31 may 2021. We classified AKI by comparing highest to lowest recorded
serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global
Outcomes (KDIGO) system. We calculated the unadjusted and adjusted odds ratio for the stage
of AKI and the need for mechanical ventilation, and in-hospital mortality.
Measurements-Stage of AKI, LOS, mechanical ventilation, discharge, and in-hospital mortality.
Results-Of the total 174 patients registered to the log book during the study time, and only 156
patients were found to be eligible for study and from this 95(60.9%) developed AKI, 36 (37.9%)
presented with AKI, and 59 (62.1%) developed AKI in-hospital. High charlson comorbidity
index, low lymphocyte count, low serum albumin level, higher white blood cell counts and
Serum alkaline phosphatase measurement, vasopressor need for life support, and mechanical
ventilation were found to be associated significantly with increased risk for AKI.
Limitations-a cohort study with small sample size limits precision of estimates. Lack of nonhospitalized
and stable admitted patients with confirmed COVID-19 as controls limits causal
inferences.
Conclusions-Acute kidney injury, whether it occurs prior to or after hospitalization, is associated
with a high risk of poor outcomes in patients with COVID-19. Routine assessment of kidney
function in patients with COVID-19 may improve risk.
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Keywords
Acute kidney injury, Patients, COVID-19