Acute kidney injury and COVID-19; incidence, risk factors, and mortality

Introduction: Acute kidney injury (AKI) is a common complication among patients infected with SARS-CoV-2, particularly in intensive care unit (ICU) settings. Understanding the incidence, risk factors, and outcomes associated with AKI in COVID-19 patients is crucial for optimizing clinical management and improving patient outcomes. Objectives: The main goal of our study was to investigate the impact of AKI on the mortality rates of COVID-19 patients. We achieved this by determining the incidence of AKI and mortality in COVID-19 patients, and by comparing mortality rates between patients with and without acute renal failure. Our aim is to highlight the importance of kidney function in hospitalized COVID-19 patients, which could lead to timely diagnosis and improved management of those who develop AKI. Patients and Methods: We conducted a retrospective observational study to investigate the incidence of AKI and its association with mortality in COVID-19 patients. A total of 125 patients diagnosed with COVID-19 were included in the study, with 93 patients who had recovered and were discharged am 32 patients who were deceased. Data was collected from 2 referral medical centers during one year. Demographic, clinical, and laboratory data were collected and analyzed to assess the incidence of AKI and its impact on patient outcomes. Results: The study found that 48.8% of COVID-19 patients developed AKI during or shortly before their hospitalization, with 57.4% requiring ICU admission. Older age was identified as a significant risk factor for AKI development, with patients in the AKI group having a significantly higher mean age compared to those without AKI (55.54 vs 65.33, P<0.001). Additionally, male gender, obesity, tobacco/opium addiction, prior tuberculosis infection, ischemic heart disease or chronic kidney disease as an underlying disease and history of kidney transplantation were shown as significant risk factors for AKI development in COVID-19 patients. After adjusting for and removing all confounding variables, two variables emerged as predictors of mortality; high creatinine levels (P=0.005) and hospitalization in the ICU (P<0.001). Conclusion: This study highlights the high incidence of AKI among COVID-19 patients, particularly in older individuals and those requiring ICU care. Importantly, AKI was associated with increased mortality, underscoring the need for early detection and management of renal complications in COVID-19 patients to improve clinical outcomes.