Abstract

Introduction:This article describes the main differences between COVID-19-induced acute kidney injury (AKI-COVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKI-CKD) treated in a high complexity clinic in Barranquilla (Colombia).Material and Methods:The patients included in this study (n: 572) were those with a positive diagnosis of COVID-19 confirmed by detection of a positive PCR for SARS-CoV-2. Of these patients, 188 developed AKI during their hospital stay. Patients’ epidemiological data, serum parameters, and clinical frailty status were recorded. Statistical analysis and comparison among AKI-NRF, AKI-CKD, and non-AKI patients were performed.Results:The incidence of COVID-19-induced AKI was 33%, with the majority classified as AKIN 1, 16% requiring renal replacement therapy, and AKI-COVID19 mortality of 68%. A significantly higher prevalence of hypertension, cardiac disease, and serum reactive C-protein and lower albumin values in AKI-CKD patients was recorded. Mortality rate, invasive ventilation requirement, and D-dimer levels were significantly higher in AKI-NRF patients:Conclusion:Different clinical patterns between AKI-NRF and AKI-CKD were documented.

Highlights

  • This article describes the main differences between COVID19-induced acute kidney injury (AKICOVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKICKD) treated in a high complexity clinic in Barranquilla (Colombia)

  • The AKI patient group was divided into two subgroups: those who had previous normal renal function (AKINRF) and those who had previous chronic kidney disease (AKI-CKD)

  • Of the 720 individuals evaluated at the emergency room of the Clínica de la Costa, Barranquilla (Colombia) from April 01 to July 11, 2020, for suspicion of COVID-19, 572 were admitted with confirmed diagnosis of SARS-CoV-2 infection

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Summary

Introduction

This article describes the main differences between COVID19-induced acute kidney injury (AKICOVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKICKD) treated in a high complexity clinic in Barranquilla (Colombia). Material and Methods: The patients included in this study (n: 572) were those with a positive diagnosis of COVID-19 confirmed by detection of a positive PCR for SARSCoV-2. Of these patients, 188 developed AKI during their hospital stay. An incidence of 3-9% was reported, ranging from urinary disorders such as albuminuria (34%), proteinuria (63%), hematuria (27%), proteinuria with hematuria (44%), to an increase in serum creatinine and urea levels due to acute kidney injury (AKI) (14-27%)[4]. Some are due to the direct deleterious effect of the virus on podocytes, tubular and endothelial cells, while others are involved in indirect kidney damage induced by reduced perfusion (shock), hypoxia (respiratory insufficiency), microangiopathy (disseminated intravascular coagulation: DIC), pigmenturia (rhabdomyolisis), immunological renal damage (cytokine storm), and drug toxicity (AINEs)[5-11]

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