Incidence of, and risk factors and outcomes associated with, acute kidney injury in COVID-19 at the national kidney and transplant institute, Philippines

• Published in: Tropical medicine and infectious disease Vol. 8; no. 8; pp. 1 - 16
• Main Authors: Altillero, Melchor, Danguilan, Romina, Arakama, Mel Hatra
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland MDPI 01.08.2023; MDPI AG
• Subjects: acute kidney injury; Acute renal failure; Chronic kidney failure; Chronic renal failure; Comorbidity; Complications; COVID-19; COVID-19 (Disease); COVID-19 diagnostic tests; Creatinine; Diabetes; Diagnosis; Diseases; Evaluation; Hemodialysis; Hospitalization; incidence; Kidney diseases; Kidneys; Liver diseases; Medical records; Mortality; Oxygen saturation; Patient outcomes; Philippines; Pneumonia; recovery; Regression analysis; Renal replacement therapy; Risk factors; Testing laboratories; Transplantation; Transplants & implants; United Kingdom; Urine; United Kingdom; Philippines
• ISSN: 2414-6366; 2414-6366
• DOI: 10.3390/tropicalmed8080387

(1) Background: Acute kidney injury (AKI) in COVID-19 leads to an increase in patient mortality, especially among chronic kidney disease (CKD) patients. (2) Methods: A retrospective cohort of 519 adults admitted from 1 March 2020 to 1 March 2022 were reviewed for baseline characteristics and their association with renal outcomes. Patients were divided into diagnosed CKD, undiagnosed CKD, and normal eGFR. Chronic dialysis and kidney-transplant patients were excluded. Kaplan-Meier survival analysis at 7, 14, and 30 days from admission was performed. (3) Results: The overall incidence of AKI was 45.66%; the proportions among patients with diagnosed CKD, undiagnosed CKD, and normal eGFR were 76.64%, 38.75%, and 7.59%, respectively ('p' < 0.0001). Multivariate analysis showed that being male and inotrope use were significant risk factors for AKI, while higher eGFR was protective. AKI was associated with dialysis, invasive ventilation ('p' < 0.0001), prolonged hospitalization ('p' = 0.0001), and mortality ('p' < 0.0001). Renal recovery was 64%, 59%, and 23% in stages 1, 2, and 3 AKI, respectively, until 14 days from discharge ('p' < 0.0001). Patient survival was lower in cases of AKI: 83.16%, 70.59%, and 47.5% compared to non-AKI figures of 91.27%, 87.82%, and 76.95% at 7, 14, and 30 days respectively('p' = 0.0001). (4) Conclusion: There was a higher incidence of AKI with worsening renal function. Intensified preventive measures for AKI are crucial to prevent its devastating consequences.