Patient-centered approach to the management of acute kidney injury in the Covid-19 outcomes.

Abstract

Aim: To identify patients at risk of AKI with severe COVID-19 and to guide management strategies according to national and global scientific data for improving kidney-related outcomes. Materials and Methods: We conducted retrospective study case-control analysing cases of hospitalisation patients with COVID-19 with or without AKI during hospital stay. Results: In the study, we found that there was a positive correlation between AKI and respiratory insufficiency (0,513 - moderate, p<0,0001), moderate in the case of AKI grade 2 (0.301, <0,001) and mild in the case of AKI grade 1 and 3 correspondingly (0.252, p<0,01; 0.277, <0,001). Lethality (in-hospital death rate) correlated with respiratory insufficiency and AKI (0.733, 0,617; p<0,0001). We found that age had a reverse correlation with AKI and RI (younger patients were more likely to have a higher prevalence of AKI and RI, p<0,001). It was noticed that AKI correlated with the minimal albumin level (-0,35, p=0,016), minimal lymphocyte count (-0.377, p<0,0001), IL-6 (0.201, p=0,035), ferritin (0.34, p <0,0001), maximal CRP (0.439, p<0,0001). There was a mild correlation between Padua Score and AKI (0,232, p<0,01) and PLRI (0,172, p=0,05). Conclusions: Early assessment of renal dysfunction could be used as a marker of severe outcomes of COVID-19, especially in the case of comorbidities such as metabolic disorders and cardiovascular events. We suggest using the Padua score, assessment of personal lethality risk index (PLRI), and rise of serum creatinine as additional tools for assessment criteria for hospitalisation.