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Acute kidney injury in COVID‐19: Identification of risk factors and potential biomarkers of disease in a large UK cohort

Acute kidney injury in COVID‐19: Identification of risk factors and potential biomarkers of disease in a large UK cohort
Acute kidney injury in COVID‐19: Identification of risk factors and potential biomarkers of disease in a large UK cohort
Background

COVID‐19 is associated with increased risk of acute kidney injury (AKI). Risk factors and biomarkers linked to AKI have now been recognized by national guidelines in the United Kingdom. This analysis aims to validate and expand the comorbidities and biomarkers associated with the presence and severity of AKI in these patients.

Methods

Data were extracted via structured query language for patients with COVID‐19 at University Hospital Southampton between 1 March and 10 June 2020. Demographics, comorbidities, common biomarkers and AKI stage within 48 hours of admission, peak during admission and the last measurement prior to patient outcome (discharge or death) were collected and statistically analysed.

Results

Six hundred and thirty‐two COVID‐19 positive patients were admitted during this period; 34.2% had an AKI during their entire admission, 20.3% had AKI stage 1, 8.5% stage 2 and 5.4% stage 3. This was higher when compared with data from the same period in 2019. AKI carried an increased risk of death, 50.0% vs 21.1% (P = <.001). AKI stage was significantly associated with age over 65, diabetes, heart failure, peripheral vascular disease, haematological malignancy, hypertension, respiratory rate, albumin, C‐reactive protein (CRP), d‐dimer, ferritin, high‐sensitivity troponin‐I, neutrophil count, total white cell counts, National Early Warning Score‐2 (NEWS‐2), Charlson comorbidity index and alanine‐aminotransferase. COVID‐19 specific treatment, including dexamethasone, reduced discharge creatinine.

Conclusion

COVID‐19 increases the risk of AKI and this kidney injury may be responsive to treatment. This analysis identified that AKI is associated with both previously described and new comorbidities and biomarkers.

1440-1797
Phillips, Thomas
53b34250-9b3d-4e9b-8983-8de30fe2bc12
Stammers, Matt
85e202da-1879-4f96-8e24-5059a1fa3f1e
Leggatt, Gary
546eb2be-3056-4e1b-bbef-66b6313280af
Bonfield, Becky
2761b0f0-6f9c-4cd9-b984-7ea07270babc
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Armstrong, Kirsten
a1dfefe3-cd0f-4609-893e-c8ee2be6080d
Veighey, Kristin
2adbaf5c-141a-44bd-a7eb-faf14e0ca251
Phillips, Thomas
53b34250-9b3d-4e9b-8983-8de30fe2bc12
Stammers, Matt
85e202da-1879-4f96-8e24-5059a1fa3f1e
Leggatt, Gary
546eb2be-3056-4e1b-bbef-66b6313280af
Bonfield, Becky
2761b0f0-6f9c-4cd9-b984-7ea07270babc
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Armstrong, Kirsten
a1dfefe3-cd0f-4609-893e-c8ee2be6080d
Veighey, Kristin
2adbaf5c-141a-44bd-a7eb-faf14e0ca251

Phillips, Thomas, Stammers, Matt, Leggatt, Gary, Bonfield, Becky, Fraser, Simon, Armstrong, Kirsten and Veighey, Kristin (2021) Acute kidney injury in COVID‐19: Identification of risk factors and potential biomarkers of disease in a large UK cohort. Nephrology. (doi:10.1111/neph.13847).

Record type: Article

Abstract

Background

COVID‐19 is associated with increased risk of acute kidney injury (AKI). Risk factors and biomarkers linked to AKI have now been recognized by national guidelines in the United Kingdom. This analysis aims to validate and expand the comorbidities and biomarkers associated with the presence and severity of AKI in these patients.

Methods

Data were extracted via structured query language for patients with COVID‐19 at University Hospital Southampton between 1 March and 10 June 2020. Demographics, comorbidities, common biomarkers and AKI stage within 48 hours of admission, peak during admission and the last measurement prior to patient outcome (discharge or death) were collected and statistically analysed.

Results

Six hundred and thirty‐two COVID‐19 positive patients were admitted during this period; 34.2% had an AKI during their entire admission, 20.3% had AKI stage 1, 8.5% stage 2 and 5.4% stage 3. This was higher when compared with data from the same period in 2019. AKI carried an increased risk of death, 50.0% vs 21.1% (P = <.001). AKI stage was significantly associated with age over 65, diabetes, heart failure, peripheral vascular disease, haematological malignancy, hypertension, respiratory rate, albumin, C‐reactive protein (CRP), d‐dimer, ferritin, high‐sensitivity troponin‐I, neutrophil count, total white cell counts, National Early Warning Score‐2 (NEWS‐2), Charlson comorbidity index and alanine‐aminotransferase. COVID‐19 specific treatment, including dexamethasone, reduced discharge creatinine.

Conclusion

COVID‐19 increases the risk of AKI and this kidney injury may be responsive to treatment. This analysis identified that AKI is associated with both previously described and new comorbidities and biomarkers.

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More information

Accepted/In Press date: 29 December 2020
e-pub ahead of print date: 1 January 2021

Identifiers

Local EPrints ID: 447001
URI: http://eprints.soton.ac.uk/id/eprint/447001
ISSN: 1440-1797
PURE UUID: 1c127237-584e-4fd5-9251-e9428b1595ae
ORCID for Gary Leggatt: ORCID iD orcid.org/0000-0001-9280-9568
ORCID for Simon Fraser: ORCID iD orcid.org/0000-0002-4172-4406

Catalogue record

Date deposited: 01 Mar 2021 17:33
Last modified: 13 Dec 2021 03:30

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Contributors

Author: Thomas Phillips
Author: Matt Stammers
Author: Gary Leggatt ORCID iD
Author: Becky Bonfield
Author: Simon Fraser ORCID iD
Author: Kirsten Armstrong
Author: Kristin Veighey

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