key: cord-0929540-b5g2cqsh
authors: shekhar, r.; Upadhyaya, S.; Shah, S.; kapuria, D.
title: COVID-19 and Acute Kidney Injury requiring Kidney Replacement Therapy: A Bad Prognostic Sign.
date: 2020-05-13
journal: nan
DOI: 10.1101/2020.05.08.20096040
sha: 56f1ccc59f93c3584971b64c3f557d4ba0e40631
doc_id: 929540
cord_uid: b5g2cqsh

The development of acute kidney injury in patients with COVID-19 is estimated to about 0.5% from earlier studies from China. The incidence of AKI in patients with COIVID-19 in the largest inpatient series in the United States is 22.2%3. Development of AKI requiring kidney replacement therapy in hospitalized patients is a bad prognostic sign. Out of Fifty patients admitted to our hospital with COVID-19 13/50(26%) developed AKI. All patients required hospitalization in intensive care unit care and 12/13 required initiation of kidney replacement therapy. The median age was 41 years (31-85 years) and 50% were men. Common comorbidities were obesity (83%), diabetes (42%), and hypertension (25%). 10/12 (83%) patients were hypoxemic and required oxygen therapy. 11/12 (92%) patients required invasive ventilation. Majority of patients had elevated neutrophils counts (81.8%) and low lymphocyte counts (81.8%). All patients had chest x-ray findings suggestive of pneumonia. 11/12(91.6%) developed septic shock requiring vasopressors. Review of UA showed all patient (9/9) had active urine sediments with blood but 7/9 of them have sterile pyuria. At the end of study period, 1 patient remained hospitalized. 10/11(90%) patients died and one patient was discharged home with resolution of AKI. Median length of stay was 13 days. The exact mechanism of AKI is not well understood in COVID-19 but can be due to acute tubular necrosis due to septic shock because of cytokine storm in severe COVID-19 or direct invasion by SARS-CoV-2 on podocytes and proximal renal tubular cells. Our findings suggest poor prognosis despite continuous kidney replacement therapies in patients who develop AKI with COVID-19.

. . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted May 13, 2020. . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted May 13, 2020. . . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted May 13, 2020. . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted May 13, 2020. . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted May 13, 2020 . . https://doi.org/10.1101 /2020 Contrast exposure (%) 0/12 (0) Nephrotoxic Drugs NSAIDS (%) 1/12(8.3) Hydronephrosis on Imaging (%) 0/3 (0) Modality of treatment CRRT/HD/Conservative CRRT 11/ 1 HD Admission icu (%) 12/12 (100) Mechanical ventilation (%) 11/12(91.6) UA positive for protein and blood (%) 9/9 (100) UA positive wbc (%) 7/9(77.7)

Median LOS in days (11/12) 13 days (1-20days) Outcome Death/Discharge/still admitted 10 death/ 1 d/c home / 1 still admitted Recovery (%) 1/11 (9) . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted May 13, 2020 . . https://doi.org/10.1101 /2020 

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