• Savaş Öztürk, Kenan Turgutalp, Mustafa Arıcı, Hakkı Çetinkaya, Mehmet Rıza Altıparmak, Zeki Aydın, Zeki Soypaçacı, Feyza Bora, Ekrem Kara, Egemen Cebeci, Tuba Elif Özler, Mürşide Esra Dölarslan, Savaş Sipahi, Yavuz Ayar, İdris Şahin, Serkan Bakırdöğen, Mahmud İslam, Numan Görgülü, Melike Betül Öğütmen, Erkan Şengül, Özkan Güngör, Nurhan Seyahi, BÜlent Tokgöz, Ali Rıza Odabaş, Halil Zeki Tonbul, Siren Sezer, Alaattin Yıldız, and Kenan Ateş.
• Department of Nephrology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey
• Turk J Med Sci. 2021 Jun 28; 51 (3): 947-961.

Background/AimHospital-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 MethodsHA-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.ResultsAmong 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.ConclusionAKI 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.This work is licensed under a Creative Commons Attribution 4.0 International License.

29 keywords...

hide…