Abstract
Abstract Background and Aims Renal complications of COVID-19 are not yet well studied. We aimed to evaluate the prevalence of acute kidney injury (AKI) among positive COVID-19 hospitalize cases and explore its impact on patient outcomes. Method 586 hospitalized patients with COVID-19 were retrospectively evaluated. of them, 267 (45.5%) developed AKI- classified according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines- compared with 319 (54.5%) patients without AKI. Results Most cases were males (72.7% vs. 69.7%), and their ages ranged (60.8± 14 vs. 51.7± 16 years). Comorbid conditions significantly predominant among the AKI group were diabetes mellitus (64 vs. 42.9%), hypertension (72.6% vs. 43.5%), and ischemic heart disease (25% vs. 14.7%). Fever, cough, shortness of breath, and dehydration were the main presentations among the AKI group, and they had significant radiological findings concordant with COVID-19 (86.8% vs. 59.8%). Sepsis, volume depletion, shock, arrhythmias, and ARDS were significantly higher in the AKI group. Anticoagulation (85% vs. 59.2%), vasopressors, plasma infusions, antimicrobials, and steroids were more frequently used in the AKI group. Acute respiratory failure requiring mechanical ventilation and the overall mortality rate were significantly higher in the AKI group (62.3% vs. 32.9% and 63.2%. vs. 31.1%, respectively). Conclusion AKI associated with severe COVID-19 was more frequent than reports from Chinese, European, and North American cohorts. AKI risk factors included COVID-19 comorbidities like hypertension, diabetes, mechanical ventilation, male gender, and older age. Mortality was high in this population, especially elderly patients, and in those who develop KDIGO stage 3 AKI.
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