The Study of Clinical Profile of Acute Kidney Injury in COVID-19 Patients

Abstract

Aim: All prior studies have demonstrated that acute renal damage in People who have the coronavirus disease of 2019 (COVID-19) are often diagnosed and have a dismal prognosis. Acute renal injury in COVID-19 patients has not been well reported in developing countries like India. Examining the clinical traits, biochemistry, and prognosis of acute kidney injury (AKI) in COVID-19 patients is the aim of this article.

Methods: - The Department of Nephrology at the Sri Aurobindo Medical College and Graduate Institute (M.P.) in Indore, India, conducted this study from April 1, 2020, to January 31, 2021. We examined 130 COVID-19 cases of AKI recorded by SAMC & PGI in Indore. Included 18-year-old and older COVID-19 patients verified by real-time reverse polymerase chain reaction (RT-PCR). The term "sepsis" was employed in its conventional sense. The Kidney Disease Improving Global Outcomes (KDIGO) guidelines of AKI were adhered to. Patients under the age of 18 undergoing renal replacement therapy for CKD in stages I to IV and ESRD were not eligible. Results – A total of 12,438 COVID patients were admitted to our hospital during this period. The incidence of AKI was 1.04% (130). The mean age was 51.2 years. The male-to-female ratio was 1.4:1 (76:54). Commonest symptoms were fever in 71.5% (93) of patients, headache in 62% (81) of patients, and cough in 51.5% (67) of patients, followed by breathlessness in 37.5% (49) patients. The typical creatinine values at the time of admission were were 3.57 mg/dl. AKI stage 1 was seen in 30% (39) cases, stage 2 in 45.5% (59) cases, and stage 3 in 24.5% (32) cases. The most common aetiology was sepsis in 65% (84) and drugs in 14% (18). T2DM was the most common comorbidity in 42% (55) of patients, HTN in 41.5% (54) of patients,Coronary Artery Disease( CAD) in 9.2% (12) of patients, and malignancy in 5% (7) of patients. Oxygen by nasal mask/nasal prongs was required in 59% (77) of patients, BIPAP in 16% (21) of patients, and ventilatory support in 12.5% (16) of patients. The average hospitalization was 12.3 days. Dialysis was required in 16% (21) of patients. Notably, 87% (113) of patients recovered completely, and 13% (17) of patients expired. The majority of patients had elevated inflammatory markers. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated in 81% (105) of patients, and ferritin was raised in 71% (92) of patients.

Conclusion: Hospitalized COVID-19 patients commonly get AKI, which is associated with a poor prognosis and high mortality. In COVID-19 patients, increased inflammatory markers, type 2 diabetes, sepsis, older age, and male sex were the main risk factors for developing acute renal injury.