Dataset Information

Long-term kidney function recovery and mortality after COVID-19-associated acute kidney injury: An international multi-centre observational cohort study.

ABSTRACT:

Background

While acute kidney injury (AKI) is a common complication in COVID-19, data on post-AKI kidney function recovery and the clinical factors associated with poor kidney function recovery is lacking.

Methods

A retrospective multi-centre observational cohort study comprising 12,891 hospitalized patients aged 18 years or older with a diagnosis of SARS-CoV-2 infection confirmed by polymerase chain reaction from 1 January 2020 to 10 September 2020, and with at least one serum creatinine value 1-365 days prior to admission. Mortality and serum creatinine values were obtained up to 10 September 2021.

Findings

Advanced age (HR 2.77, 95%CI 2.53-3.04, p < 0.0001), severe COVID-19 (HR 2.91, 95%CI 2.03-4.17, p < 0.0001), severe AKI (KDIGO stage 3: HR 4.22, 95%CI 3.55-5.00, p < 0.0001), and ischemic heart disease (HR 1.26, 95%CI 1.14-1.39, p < 0.0001) were associated with worse mortality outcomes. AKI severity (KDIGO stage 3: HR 0.41, 95%CI 0.37-0.46, p < 0.0001) was associated with worse kidney function recovery, whereas remdesivir use (HR 1.34, 95%CI 1.17-1.54, p < 0.0001) was associated with better kidney function recovery. In a subset of patients without chronic kidney disease, advanced age (HR 1.38, 95%CI 1.20-1.58, p < 0.0001), male sex (HR 1.67, 95%CI 1.45-1.93, p < 0.0001), severe AKI (KDIGO stage 3: HR 11.68, 95%CI 9.80-13.91, p < 0.0001), and hypertension (HR 1.22, 95%CI 1.10-1.36, p = 0.0002) were associated with post-AKI kidney function impairment. Furthermore, patients with COVID-19-associated AKI had significant and persistent elevations of baseline serum creatinine 125% or more at 180 days (RR 1.49, 95%CI 1.32-1.67) and 365 days (RR 1.54, 95%CI 1.21-1.96) compared to COVID-19 patients with no AKI.

Interpretation

COVID-19-associated AKI was associated with higher mortality, and severe COVID-19-associated AKI was associated with worse long-term post-AKI kidney function recovery.

Funding

Authors are supported by various funders, with full details stated in the acknowledgement section.

SUBMITTER: Tan BWL

PROVIDER: S-EPMC9640184 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Long-term kidney function recovery and mortality after COVID-19-associated acute kidney injury: An international multi-centre observational cohort study.

Tan Byorn W L BWL Tan Bryce W Q BWQ Tan Amelia L M ALM Schriver Emily R ER Gutiérrez-Sacristán Alba A Das Priyam P Yuan William W Hutch Meghan R MR García Barrio Noelia N Pedrera Jimenez Miguel M Abu-El-Rub Noor N Morris Michele M Moal Bertrand B Verdy Guillaume G Cho Kelly K Ho Yuk-Lam YL Patel Lav P LP Dagliati Arianna A Neuraz Antoine A Klann Jeffrey G JG South Andrew M AM Visweswaran Shyam S Hanauer David A DA Maidlow Sarah E SE Liu Mei M Mowery Danielle L DL Batugo Ashley A Makoudjou Adeline A Tippmann Patric P Zöller Daniela D Brat Gabriel A GA Luo Yuan Y Avillach Paul P Bellazzi Riccardo R Chiovato Luca L Malovini Alberto A Tibollo Valentina V Samayamuthu Malarkodi Jebathilagam MJ Serrano Balazote Pablo P Xia Zongqi Z Loh Ne Hooi Will NHW Chiudinelli Lorenzo L Bonzel Clara-Lea CL Hong Chuan C Zhang Harrison G HG Weber Griffin M GM Kohane Isaac S IS Cai Tianxi T Omenn Gilbert S GS Holmes John H JH Ngiam Kee Yuan KY

EClinicalMedicine 20221107

<h4>Background</h4>While acute kidney injury (AKI) is a common complication in COVID-19, data on post-AKI kidney function recovery and the clinical factors associated with poor kidney function recovery is lacking.<h4>Methods</h4>A retrospective multi-centre observational cohort study comprising 12,891 hospitalized patients aged 18 years or older with a diagnosis of SARS-CoV-2 infection confirmed by polymerase chain reaction from 1 January 2020 to 10 September 2020, and with at least one serum cr ...[more]

PMID: 36381999

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Dataset Information

Long-term kidney function recovery and mortality after COVID-19-associated acute kidney injury: An international multi-centre observational cohort study.

Background

Methods

Findings

Interpretation

Funding

Publications

Long-term kidney function recovery and mortality after COVID-19-associated acute kidney injury: An international multi-centre observational cohort study.

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