AKI Common in U.S. Veterans Hospitalized With COVID-19

MONDAY, Nov. 16, 2020 — Acute kidney injury (AKI) is common among U.S. veterans hospitalized with COVID-19 and is associated with an increased risk for health care resource utilization and death, according to a study published online Nov. 16 in the Clinical Journal of the American Society of Nephrology.

Benjamin Bowe, M.P.H., from the VA Saint Louis Health Care System, and colleagues describe the rates and characterized predictors and health outcomes associated with AKI among 5,216 U.S. veterans hospitalized with COVID-19.

The researchers found that 32 percent of participants had AKI, with 58, 13, and 16 percent, respectively, meeting the Kidney Disease Improving Global Outcomes definitions of stage 1, 2, and 3 AKI; 12 percent received kidney replacement therapy. Within one day of hospitalization, 80 percent of participants had AKI, and 47 percent did not recover to baseline serum creatinine by discharge. Significant predictors of AKI during COVID-19 hospitalization included Black race, male gender, obesity, diabetes, hypertension, and lower estimated glomerular filtration rate. AKI correlated with higher mechanical ventilation use (odds ratio, 6.46) and longer hospital stay (5.56 additional days), as well as with a higher risk for death (odds ratio, 6.71), with a stronger correlation observed in Black patients.

“Nearly half of the veterans with AKI left the hospital with unresolved AKI — meaning that they will likely need long term follow up and care,” a coauthor said in a statement. “Their kidneys are scarred by COVID-19. Unresolved AKI and its long-term consequences are going to be part of the ‘long-haul COVID-19.'”

Two authors disclosed financial ties to KidneyCure.

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