AKI is associated with high mortality rate in COVID-19 patients

According to a recent study published in the American Journal of Kidney Diseases, AKI in hospitalized patients with COVID-19 is associated with significant risk of mortality, which is amplified even more when AKI requires kidney replacement therapy (KRT). 1

Researchers conducted an observational retrospective study of 9657 hospitalized COVID-19 patients in 13 metropolitan hospitals in NY City in order to rigorously analyze in-hospital mortality and kidney outcomes among those that developed AKI.
Their findings demonstrated a 40% AKI incidence rate in this population.

Among the 5,801 patients without AKI, 7.3% experienced in-hospital death, or 10.8 deaths/1000 patient-days. Among the 3216 patients that developed AKI but did not require KRT, 46.4% died, or 31.1 deaths/1000 patient-days. Among the 638 patients that developed AKI and did require KRT, 79.3% died, or 37.5 deaths/1000 patient- days. AKI was defined according to the KDIGO criteria.

Of the AKI patients that did not require KRT and survived, 74.1% achieved kidney recovery by the time of discharge. Among those AKI patients that did require KRT and survived, 30.6% remained on dialysis at discharge In contrast to several other recent publications, where large numbers of patients did not have completed outcomes, over 99% of the patients in this study had completed outcomes.

The significant in-hospital mortality rate among patients with COVID-19 who develop AKI, and in particular those who received KRT, underscores the need for shared decision-making in these critically ill patients.


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  1. Ng JH, Hirsch JS, Hazzan A, Wanchoo R et al. Outcomes Among Patients Hospitalized With COVID-19
    and Acute Kidney Injury. American Journal of Kidney Diseases (2020), https://doi.org/10.1053/j.ajkd.2020.09.002
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