AKI incidence during hospitalization for COVID-19 declined throughout 2020
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Incidence of COVID-19-associated acute kidney injury declined between March and November 2020, according to a report that examined temporal trends of the condition at New York City hospitals throughout the pandemic.
“While we did not do formal analysis into reasons for this change, we speculate that the changes are multifactorial and likely related to changes in patient demographics, newly available therapeutic options, improved experience of clinicians, and better resource allocation due to a decrease in case load,” Sergio Dellepiane, MD, PhD, of Icahn School of Medicine at Mount Sinai, told Healio Nephrology.
The results were presented virtually during the National Kidney Foundation Spring Clinical Meetings.
Utilizing electronic health record data of 6,216 patients hospitalized with the virus, Dellepiane and colleagues assessed AKI incidence from March 1 to Nov. 30, 2020. They also evaluated trends of AKI in specific subgroups based on age, sex, race and preexisting chronic kidney disease. Individuals receiving maintenance dialysis treatments at the time of hospitalization, or who had undergone kidney transplantation, were excluded.
Results showed AKI incidence decreased from over 40% during the first outbreak (defined as March to May 2020, with a peak in hospitalizations occurring in April) to 22% in June; by November, AKI incidence had declined to 11%.
In addition, the researchers observed a decrease in the proportion of patients who required dialysis due to COVID-19-associated AKI, from 20% in March 2020 to 6% in December.
Although patients in each subgroup experienced consistent decreases in AKI incidence, Dellepiane said patients who were older, had preexisting CKD or who were Black were more likely to develop AKI at each stage of the pandemic.
As such, he recommended further research to examine how social determinants of health might influence the observed differences in AKI incidence among subgroups.
“Although rates have declined, AKI in COVID-19 remains a common complication of COVID-19,” Dellepiane said, adding that it is important to identify patients at high risk for the condition early in their hospitalization and that closer monitoring or “more aggressive therapeutic management” may be beneficial.
“We will also need to see how AKI incidence will change now that a COVID-19 vaccine is available,” he said.
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Dellepiane S, et al. Abstract #9. Presented at: National Kidney Foundation Spring Clinical Meetings (virtual meeting); April 6-10, 2021.
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