Kidney Disease, Injury Linked to Higher Mortality With COVID-19

TUESDAY, Oct. 20, 2020 -- Renal impairment in patients admitted to intensive care with COVID-19 is common and is associated with high mortality, according to a study published online Oct. 16 in Anaesthesia.

Marisa Gasparini, M.B.B.S., from the Imperial College Healthcare NHS Trust in London, and colleagues examined the association between acute and chronic kidney disease and clinical outcomes in 372 patients with COVID-19 admitted to four regional intensive care units (ICUs) between March 10 and July 31, 2020.

The researchers found that 58 percent of patients presented with COVID-19 and renal impairment (45 percent developed acute kidney injury [AKI] during their ICU stay and 13 percent had preexisting chronic kidney disease [CKD]). Compared with patients with preserved renal function, patients with AKI and/or CKD had greater in-hospital mortality (21 versus 50 percent; relative risk, 2.4). Mortality was greatest in patients with renal transplants (six of seven patients). Mortality rates increased with worsening renal injury (Kidney Disease: Improving Global Outcomes classification stage 0: mortality, 21 percent; stages 1 to 3: mortality, 49 percent; relative risk 2.3). Compared with nonsurvivors, survivors were less likely to require renal replacement therapy (46 versus 24 percent; relative risk, 1.9). Of survivors who required renal replacement therapy acutely in intensive care, one-fifth continued to require renal support following discharge.

"Our findings have important implications for future pandemic planning in this patient cohort," the authors write.

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Posted: October 2020