To evaluate the prevalence, risk factors and prognostic significance of acute kidney injury (AKI) in the Russian cohort of hospitalised patients with COVID-19.
Material and methods
We enrolled 1280 consecutive hospitalized patients with COVID-19 in a retrospective study. Diagnosis of COVID-19 was verified by PCR and/or typical CT findings. Changes in serum creatinine were evaluated during hospitalisation to diagnose AKI according to KDIGO criteria. Factors associated with development of AKI and its prognostic significance were studied using multiple regression models.
Mild to moderate proteinuria (0.3 to 3 g/L) was found in 648 (50.6%) patients with COVID-19, hematuria in 77 (6.0%) patients, and leucocyturia in 282 (22.0%) patients. After admission, AKI occurred in 371 (28.9%) patients. Most of them presented with mild increase in serum creatinine, whereas only 10 (2.7%) patients required treatment with hemodialysis. Independent risk factors for AKI included age over 65 years, elevated inflammatory biomarkers (C-reactive protein and ferritin), D-dimer and ACTT. 162 (12.7%) of 1280 patients with COVID-19 died in the hospital. AKI was associated with a higher risk of death (hazards ratio of 3.96, 95% confidence interval 2.83-5.54).
AKI frequently occurred in hospitalized patients with COVID-19 and was associated with a higher risk of death. Inflammatory response and thrombosis contribute significantly to AKI in patients with COVID-19.
COVID-19, acute kidney injury, inflammatory biomarkers, D-dimer.