Identify the Risk Factors of COVID-19-Related Acute Kidney Injury: A Single-Center, Retrospective Cohort Study

Wang, Jing; Wang, Zhixian; Zhu, Yunpeng; Li, Haichao; Yuan, Xiaoning; Wang, Xiaoning; Wang, Yuxi; Hu, Jinqian; Feng, Chunxiang; Liu, Chang; Liu, Shiliang; Yu, Kai; Li, Xing; Zeng, Xiaoyong

Background: The kidney is a target organ that could be infected by SARS-CoV-2, and acute kidney injury (AKI) was associated with a higher risk of COVID-19 patients' in-hospital death. However, no published works discussed about the risk factors of COVID-19 related AKI. Methods: We conducted a retrospective cohort study, recruiting COVID-19 inpatients from the Sino-French branch of Tongji Hospital. Demographic, clinical, treatment, and laboratory data were collected and compared. We used univariable and multivariable logistic regression methods to identify the risk factors of COVID-19-related AKI. Results: Of the 116 patients in our study, 12 (10.3%) were recognized as AKI, including 5 (4.3%) in-hospital AKI. Multivariable regression showed increasing odds of COVID-19-related AKI associated with COVID-19 clinical classification (OR = 8.155, 95% CI = 1.848–35.983, ref = non-critical, p = 0.06), procalcitonin more than 0.1 ng/mL (OR = 4.822, 95% CI = 1.095–21.228, p = 0.037), and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) (OR = 13.451, 95% CI = 1.617–111.891, p = 0.016). Conclusions: COVID-19-related AKI was likely to be related to multiorgan failure rather than the kidney tropism of SARS-CoV-2. The potential risk factors of COVID-19 clinical classification, procalcitonin more than 0.1 ng/mL, and eGFR <60 mL/min/1.73 m(2) could help clinicians to identify patients with kidney injury at an early stage.