Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology

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dc.authoridAyar, Yavuz/0000-0003-4607-9220
dc.authoridkurultak, ilhan/0000-0001-5607-1375
dc.authoridSahutoglu, Tuncay/0000-0003-2015-4421
dc.authoridYüksel, ENVER/0000-0003-0302-932X
dc.authoridDheir, Hamad/0000-0002-3569-6269
dc.authoridAyar, Yavuz/0000-0003-4607-9220
dc.authoridDheir, Hamad/0000-0002-3569-6269
dc.authorwosidAyar, Yavuz/AGF-0767-2022
dc.authorwosidIslam, Mahmud/K-9476-2015
dc.authorwosidkurultak, ilhan/V-1616-2019
dc.authorwosidSahutoglu, Tuncay/J-5587-2019
dc.authorwosidYüksel, ENVER/GSN-1026-2022
dc.authorwosidDheir, Hamad/CAG-5091-2022
dc.authorwosidGİBYELİ GENEK, Dilek/JOK-2735-2023
dc.contributor.authorArikan, Hakki
dc.contributor.authorOzturk, Savas
dc.contributor.authorTokgoz, Bulent
dc.contributor.authorDursun, Belda
dc.contributor.authorSeyahi, Nurhan
dc.contributor.authorTrabulus, Sinan
dc.contributor.authorIslam, Mahmud
dc.date.accessioned2024-08-04T20:50:32Z
dc.date.available2024-08-04T20:50:32Z
dc.date.issued2021
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI. Methods In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients. Results The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality. Conclusions Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.en_US
dc.description.sponsorshipTurkish Society of Nephrologyen_US
dc.description.sponsorshipThe study was unconditionally supported by the Turkish Society of Nephrology.en_US
dc.identifier.doi10.1371/journal.pone.0256023
dc.identifier.issn1932-6203
dc.identifier.issue8en_US
dc.identifier.pmid34375366en_US
dc.identifier.scopus2-s2.0-85112344732en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0256023
dc.identifier.urihttps://hdl.handle.net/11616/100116
dc.identifier.volume16en_US
dc.identifier.wosWOS:000683572000008en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherPublic Library Scienceen_US
dc.relation.ispartofPlos Oneen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCoronavirus Disease 2019en_US
dc.subjectClinical Characteristicsen_US
dc.subjectDialysis Patientsen_US
dc.subjectTransplanten_US
dc.subjectMortalityen_US
dc.subjectWuhanen_US
dc.subjectInfectionen_US
dc.subjectCkden_US
dc.titleCharacteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrologyen_US
dc.typeArticleen_US

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