Abstract
Acute kidney injury (AKI) is frequently associated with COVID-19 and it is considered an indicator of disease severity. This study aimed to develop a prognostic score for predicting in-hospital mortality in COVID-19 patients with AKI (AKI-COV score). This was a cross-sectional multicentre prospective cohort study in the Latin America AKI COVID-19 Registry. A total of 870 COVID-19 patients with AKI defined according to the KDIGO were included between 1 May 2020 and 31 December 2020. We evaluated four categories of predictor variables that were available at the time of the diagnosis of AKI: (1) demographic data; (2) comorbidities and conditions at admission; (3) laboratory exams within 24 h; and (4) characteristics and causes of AKI. We used a machine learning approach to fit models in the training set using tenfold cross-validation and validated the accuracy using the area under the receiver operating characteristic curve (AUC-ROC). The coefficients of the best model (Elastic Net) were used to build the predictive AKI-COV score. The AKI-COV score had an AUC-ROC of 0.823 (95% CI 0.761–0.885) in the validation cohort. The use of the AKI-COV score may assist healthcare workers in identifying hospitalized COVID-19 patients with AKI that may require more intensive monitoring and can be used for resource allocation.
Highlights
Acute kidney injury (AKI) is frequently associated with COVID-19 and it is considered an indicator of disease severity
The present study aimed to develop and validate a prognostic model for acute kidney injury (AKI) associated with COVID-19 patients using data from the Latin America COVID-AKI R egistry[13]
The results of the Elastic Net model showed that mechanical ventilation (MV), higher age, vasopressors, higher leukocyte values, higher aspartate aminotransferase (AST) values, severe/moderate condition at admission, hypertension, HA-AKI, AKI aetiology related to sepsis or COVID-19, higher creatinine levels during hospitalisation and indications for Kidney replacement therapy (KRT) were related to a worse outcome
Summary
Acute kidney injury (AKI) is frequently associated with COVID-19 and it is considered an indicator of disease severity. This study aimed to develop a prognostic score for predicting in-hospital mortality in COVID-19 patients with AKI (AKI-COV score). This was a cross-sectional multicentre prospective cohort study in the Latin America AKI COVID-19 Registry. The estimated incidence of acute kidney injury (AKI) among patients hospitalized for COVID-19 varies between studies, ranging from 0.5% to as high as 60%4–6. It is important to provide an accurate estimation of mortality in COVID-19 patients with AKI and to explore the differences in these estimations. This approach will improve treatment strategies and facilitate healthcare planning
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have