Cited by 1,523Acute Kidney Injury ResearchCOVID-19 Clinical Research StudiesChronic Kidney Disease and Diabetes

Acute kidney injury in patients hospitalized with COVID-19

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Hirsch, Jamie S., Ng, Jia H., Ross, Daniel W., Sharma, Purva, Shah, Hitesh H., Barnett, Richard L., Hazzan, Azzour D., Fishbane, Steven +37 more·2020·Kidney International

Abstract

The rate of acute kidney injury (AKI) associated with patients hospitalized with Covid-19, and associated outcomes are not well understood. This study describes the presentation, risk factors and outcomes of AKI in patients hospitalized with Covid-19. We reviewed the health records for all patients hospitalized with Covid-19 between March 1, and April 5, 2020, at 13 academic and community hospitals in metropolitan New York. Patients younger than 18 years of age, with end stage kidney disease or with a kidney transplant were excluded. AKI was defined according to KDIGO criteria. Of 5,449 patients admitted with Covid-19, AKI developed in 1,993 (36.6%). The peak stages of AKI were stage 1 in 46.5%, stage 2 in 22.4% and stage 3 in 31.1%. Of these, 14.3% required renal replacement therapy (RRT). AKI was primarily seen in Covid-19 patients with respiratory failure, with 89.7% of patients on mechanical ventilation developing AKI compared to 21.7% of non-ventilated patients. 276/285 (96.8%) of patients requiring RRT were on ventilators. Of patients who required ventilation and developed AKI, 52.2% had the onset of AKI within 24 hours of intubation. Risk factors for AKI included older age, diabetes mellitus, cardiovascular disease, black race, hypertension and need for ventilation and vasopressor medications. Among patients with AKI, 694 died (35%), 519 (26%) were discharged and 780 (39%) were still hospitalized. AKI occurs frequently among patients with Covid-19 disease. It occurs early and in temporal association with respiratory failure and is associated with a poor prognosis.

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  • According to studies, the incidence of AKI ranges between 46 percent and 71 percent; however, most deaths occur within the AKI sample.

    “According to studies, the incidence of AKI ranges between 46 percent and 71 percent; however, most deaths occur within the AKI sample [87, 88].”

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  1. [35]EQUATOR Network The Reporting of Studies Conducted Using Observational Routinely-Collected Health Data (RECORD) statement Available at: https://www.equator-network.org/reporting-guidelines/record PMC4595218 26440803

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Authors
Hirsch, J. S., Ng, J. H., Ross, D. W., Sharma, P., Shah, H. H., Barnett, R. L., Hazzan, A. D., Fishbane, S., Jhaveri, K. D., Abate, M., Andrade, H. P., Barnett, R. L., Bellucci, A., Bhaskaran, M. C., Corona, A. G., Chang, B. F., Finger, M., Fishbane, S., Gitman, M., Halinski, C., Hasan, S., Hazzan, A. D., Hirsch, J. S., Hong, S., Jhaveri, K. D., Khanin, Y., Kuan, A., Madireddy, V., Malieckal, D., Muzib, A., Nair, G., Nair, V. V., Ng, J. H., Parikh, R., Ross, D. W., Sakhiya, V., Sachdeva, M., Schwarz, R., Shah, H. H., Sharma, P., Singhal, P. C., Uppal, N. N., Wanchoo, R., Chang, B. S. F., & Ng, J. H.
Affiliations
Donald & Barbara Zucker School of Medicine at Hofstra/Northwell (US)
Venue
Kidney International
Publisher
Elsevier BV
Published
2020-07
Volume
98
Issue
1
Pages
209-218
ISSN
0085-2538 (ISSN-L)
OpenAlex
W3025305522
Cited by
1,523
References
31
Citations by year
2026: 37 · 2025: 65 · 2024: 120 · 2023: 203 · 2022: 341 · 2021: 462 · 2020: 288 · 2019: 1
FWCI
204.96
Type
journal article
Language
en
Open access
Locations
  • Kidney International (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK118017)
Topics
  • Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
acute kidney injury, COVID-19 pandemic, hospitalized patients, risk factors, mechanical ventilation, respiratory failure, renal replacement therapy, AKI staging, mortality, diabetes mellitus, vasopressors, racial disparities
MeSH terms
COVID-19, Aged, Female, Humans, Inpatients, Male, Middle Aged, New York City, Pneumonia, Viral, Respiratory Insufficiency, Retrospective Studies, Coronavirus Infections, Acute Kidney Injury, Pandemics

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