#3471 incidence, risk factors and outcomes associated with acute kidney injury in covid-19 at the national kidney and transplant institute

Abstract Background and Aims Acute kidney injury (AKI) in COVID-19 leads to an increase in patient mortality especially among chronic kidney disease (CKD) patients. This study aims to determine the incidence and risk factors for AKI and compare renal outcomes and survival among patients with and without AKI admitted for Covid-19 at a tertiary renal center. Methods A retrospective cohort of 519 adult patients admitted from March 1,2020 to March 1, 2022, reviewed baseline characteristics and their association with renal outcomes. Patients were divided according to diagnosed CKD, undiagnosed CKD and normal eGFR. Chronic dialysis and kidney transplant patients were excluded. Kaplan-Meier survival at 7, 14 and 30 days from admission was performed. Patients were followed up to 14 days from discharge. Results Overall incidence of AKI was 45.66%; 76.64%, 38.75%, 7.59% among patients with diagnosed CKD, undiagnosed CKD and normal eGFR respectively (p<0.0001). Multivariate analysis showed males and inotrope use were significant risk factors for AKI, while higher eGFR was protective. AKI was associated with dialysis, invasive ventilation (p<0.0001), prolonged hospitalization (p = 0.0001) and mortality (p<0.0001). Renal recovery was 64%, 59%, 23% in stage 1, 2 and 3 AKI respectively, until 14 days from discharge (p<0.0001). No significant difference was observed with renal recovery and COVID-19 severity. Patient survival was lower with AKI, 83.16%, 70.59%, 47.5% compared to non-AKI, 91.27%, 87.82, 76.95% at 7, 14, and 30 days respectively (p = 0.0001). Conclusion There was a higher incidence of AKI with worsening renal function. Intensified preventive measures for AKI is crucial to prevent its devastating consequences.