Incidence and Risk Factors for Acute Kidney Injury and its effect on Mortality in Patients Hospitalized from Covid-19

Nimkar, Abhishek; Naaraayan, Ashutossh; Hasan, Amrah; Pant, Sushil; Durdevic, Momcilo; Suarez, Corina Nava; Elenius, Henrik; Hambardzumyan, Aram; Lakshmi, Kameswari; Mandel, Michael; Jesmajian, Stephen

Abstract Objective To determine the incidence of and risk-factors for development of acute kidney injury (AKI) and investigate the association between AKI and mortality in patients hospitalized with Covid-19. Patients and Methods This retrospective case series includes the first 370 patients consecutively hospitalized with confirmed Covid-19 illness between March 10, 2020 and May 13, 2020, at a 242-bed teaching hospital. To determine independent association between demographic factors, comorbidities and AKI incidence, multivariable-logistic regression models were used to estimate odds ratios adjusted for clinical covariates. Results Median age of patients was 71 (59–82) years and 44.3% were female. Patients with AKI were significantly older with a higher comorbidity-burden and mortality-rate (58.1% vs 19.6%, p<.001) when compared to those without AKI. Increasing age, chronic kidney disease, hyperlipidemia and being of African-American descent showed higher odds of AKI. Patients with AKI had significantly higher odds of mortality when compared to patients without AKI, and this effect was proportional to the stage of AKI. Increasing age and acute respiratory distress syndrome also revealed higher adjusted odds of mortality. Conclusion AKI is a common complication among hospitalized Covid-19 patients. We found significantly higher odds of AKI with increasing age, among hyperlipidemics and patients with chronic kidney disease and among African-Americans. We demonstrate an independent association between AKI and mortality with increasingly higher odds of mortality from progressively worsening renal failure in hospitalized Covid-19 patients.