Acute kidney injury in moderate and severe COVID‑19 patients: Report of two university hospitals

Abstract

Acute kidney injury (AKI) is one of the most severe complications of SARS‑CoV‑2 infection. In a retrospective study, we aimed to describe the influence of COVID‑19‑related factors on the severity, outcome and timing of AKI in 268 patients admitted in two large COVID‑19‑designated university hospitals over a period of 6 months. In the univariate analysis, there was a significant relationship between KDIGO stage and the extension of COVID‑19 pneumonia on computed tomography (CT), need for oxygen supplementation, serum levels of ferritin, interleukin‑6, and procalcitonin, but none of these variables had a value for predicting KDIGO stage in multinomial regression. The odds of recovery of renal function were significantly diminished by d‑dimer values. Lack of immunomodulatory treatment was found to be correlated with increased need for renal replacement therapy (RRT). Compared with AKI at admission, hospital‑acquired AKI was predicted by the severity of lung damage on CT, evolved more frequently with incomplete recovery of renal function, and was significantly associated with antiviral therapy.