Acute kidney injury in COVID-19: A single-center experience in Nigeria

Abstract

Background & objective: Despite available data from developed countries, suggesting a high incidence of acute kidney injury (AKI) in coronavirus disease 2019 (COVID–19), there is scarce data from African countries, including Nigeria. We conducted this study to determine and document the incidence, the associated factors and the outcome (in–hospital mortality) of AKI among COVID–19 patients managed in a center in Nigeria. Methodology: It was a retrospective review of confirmed COVID–19 cases managed at a center in Nigeria. AKI was defined using 2012 Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria. We extracted relevant data from the electronic records of the COVID–19 patients admitted to our hospital and analyzed. Fischer's exact tests were used to test factors associated with AKI for discrete variables, Mann–Whitney U test was used for skewed continuous data, and T–test for continuous normal distribution variables. Results: This study involved 41 of the 56 confirmed COVID–19 cases. The mean age was 45 ± 17.94 y. A majority of the patients were males (33; 80.5%). AKI occurred in 6 (14.6%) of the patients. Of the 6 AKI; 4 (66.7%) and 2 (33.3%) were in stages 1 and 3 respectively. One patient (16.7%) had had hemodialysis. Of the 6 with AKI, 3 died with a mortality rate of 50.0%. Factors associated with AKI included age above 45 years, body weakness, severe and critical COVID, urea > 10 mmol/l, and serum creatinine > 1.5 mg/dl. Only severe and critical disease was predictive of AKI (adjusted odds ratio 1.777, 95% CI 1.028, 3.074). Conclusion: The results of our study show that AKI is common in severe and critical COVID–19 and is associated with a poor outcome. Key words: Acute kidney injury; AKI; COVID–19; Mortality Abbreviations: AKI – Acute kidney injury; KDIGO – Kidney Disease: Improving Global Outcomes 2012; eGFR – estimated glomerular filtration rate; MDRD – Modification of Diet in Renal Disease Ethical Review Committee Approval: MOH/ADM/SUB/1152/1/374 Citation: Ibrahim OR, Taofeek Oloyede T , Gbadamosi H , Musa Y , Aliu R , Bello SO , Alao MA , Suleiman MS , Adedoyin OT. Acute kidney injury in COVID–19: A single–center experience in Nigeria. Anaesth. pain intensive care 2021;25(4):470–477. DOI: 10.35975/apic.v25i4.1567