Prevalence, Risk Factors and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized for COVID-19: A Comparative Study between Diabetic and Nondiabetic Patients.

Elham Askari,Meghdad Sedaghat,Shayesteh Khalili,Zahra Soroureddin,Tahereh Sabaghian,Neda Khalili

doi:10.1155/2021/6666086

Abstract

Background The risk factors for acute kidney injury (AKI) development in patients with diabetes hospitalized for COVID-19 have not been fully studied yet. In this study, we aimed to estimate the rate of AKI among the hospitalized population with COVID-19 and to identify the risk factors associated with AKI among patients with diabetes. Material and Methods. This retrospective cohort study included 254 patients (127 with diabetes and 127 without diabetes) who were admitted for COVID-19 to a tertiary hospital in Tehran, Iran, between February and May 2020. Clinical characteristics and outcomes, radiological findings, and laboratory data, including data on AKI, hematuria, and proteinuria were recorded and analyzed. Results Of 254 patients, 142 (55.9%) were male and the mean (± SD) age was 65.7 years (±12.5). In total, 58 patients (22.8%) developed AKI during hospitalization, of whom 36 patients had diabetes (p = 0.04); most patients (74.1%) had stage 1 or 2 AKI. Also, 8 patients (13.8%) required renal replacement therapy (RRT) after developing AKI. Regardless of diabetes status, patients who developed AKI had significantly higher mortality rates compared with patients who did not develop AKI (p = 0.02). Hematuria and proteinuria were observed in 38.1% and 55% of patients, respectively. Multivariate analysis showed that invasive mechanical ventilation, proteinuria, HBA1c level, history of cardiovascular disease, and use of statins were independent risk factors for AKI development in patients with diabetes. Conclusion Results of this study showed that AKI develops in a considerable percentage of patients with COVID-19, especially in those with diabetes, and is significantly associated with mortality.

Highlights

Based on the world health organization (WHO) situation report dated August 6, 2020, more than 18.6 million confirmed cases of coronavirus disease-2019 (COVID-19) and approximately 703000 deaths have been reported worldwide [1]
This study is aimed at estimating the prevalence of acute kidney injury (AKI) in patients hospitalized for COVID-19, to investigate whether patients with diabetes are at higher risk of developing AKI compared with patients without diabetes and to identify the risk factors for AKI development
There was a significant positive association between the severity of AKI and mortality (p = 0:01Þ: There was a marginally significant association between AKI development and invasive mechanical ventilation (p = 0:06); the need for invasive mechanical ventilation significantly differed across the stages of AKI (p = 0:003) (Table 5). In this retrospective cohort study, among 254 patients hospitalized for COVID-19 (127 with diabetes and 127 without diabetes), 58 patients (22.8%) developed AKI during hospitalization; patients with diabetes were more likely to develop AKI and experienced more severe AKI compared with patients without diabetes

Summary

Introduction

Based on the world health organization (WHO) situation report dated August 6, 2020, more than 18.6 million confirmed cases of coronavirus disease-2019 (COVID-19) and approximately 703000 deaths have been reported worldwide [1]. Journal of Diabetes Research mechanical ventilation, older age, and cardiovascular disease are shown to be associated with greater risk of AKI development [6,7,8]. Initial reports from some of the hardest-hit countries during the COVID-19 pandemic indicated that older individuals, male patients, and those with underlying comorbidities are at increased risk for morbidity and mortality associated with COVID-19 pneumonia [11,12,13] Among these subpopulations, the management of COVID-19 in patients with diabetes has been of significant importance, considering the greater risk of AKI development and the caution needed for use of specific medications in these patients [14]. We aimed to estimate the rate of AKI among the hospitalized population with COVID-19 and to identify the risk factors associated with AKI among patients with diabetes. Results of this study showed that AKI develops in a considerable percentage of patients with COVID-19, especially in those with diabetes, and is significantly associated with mortality

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Conclusion