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Deprecated: Implicit conversion from float 300.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Turk+J+Med+Sci 2021 ; 51 (3): 947-961 Nephropedia Template TP
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Impact of hospital-acquired acute kidney injury on Covid-19 outcomes in patients with and without chronic kidney disease: a multicenter retrospective cohort study #MMPMID33611868
Ozturk S; Turgutalp K; Arici M; Cetinkaya H; Altiparmak MR; Aydin Z; Soypacaci Z; Bora F; Kara E; Cebeci E; Ozler TE; Dolarslan ME; Sipahi S; Ayar Y; Sahin I; Bakirdogen S; Islam M; Gorgulu N; Ogutmen MB; Sengul E; Gungor O; Seyahi N; Tokgoz B; Odabas AR; Tonbul HZ; Sezer S; Yildiz A; Ates K
Turk J Med Sci 2021[Jun]; 51 (3): 947-961 PMID33611868show ga
BACKGROUND/AIM: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. MATERIALS AND METHODS: HA-AKI development was assessed in a group of stage 3-5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. RESULTS: Among 621 hospitalized patients (age 60 [IQR: 47-73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9-44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9-33.3) were significantly higher than that of the non-AKI+non-CKD group. CONCLUSION: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients.
|*SARS-CoV-2[MESH]
|Acute Kidney Injury/epidemiology/*etiology[MESH]
|Aged[MESH]
|COVID-19/complications/*epidemiology[MESH]
|Female[MESH]
|Hospital Mortality/trends[MESH]
|Humans[MESH]
|Incidence[MESH]
|Intensive Care Units/*statistics & numerical data[MESH]