Intubated patients with COVID-19 pneumonia, AKI are at an increased risk for CKD
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BOSTON — Intubated patients with COVID-19 pneumonia who develop AKI in the hospital are at risk for developing chronic kidney disease, according to a presenter at the National Kidney Foundation Spring Clinical Meetings.
“We already had an idea that intubated COVID-19 pneumonia patients were at risk of developing AKI, and we knew that these patients don’t do well in the acute setting,” Sherida Edding, MD, of Lincoln Medical and Mental Health Center in New York, told Healio. “But we had patients who survived, and we were curious if this would put a toll on their kidneys. Will this episode of AKI put them at risk of developing CKD? There weren’t much longitudinal data available.”
In a retrospective case control study, researchers evaluated data on 56 patients with COVID-19 pneumonia and 69 patients with bacterial pneumonia. All 125 patients developed AKI during hospital admission and were discharged alive between Jan. 1, 2020, and Dec. 30, 2020.
Using logistic regression analysis, researchers identified the odds ratio for CKD on day 90 following a patient’s first AKI episode. Additionally, researchers used Cox proportional hazard ratios to measure the risk of CKD at day 90.
Analyses revealed the emergent in-patient hemodialysis rate was higher among patients with COVID-19 pneumonia (20%) than those with bacterial pneumonia (7%). Consequently, those with COVID-19 pneumonia were more likely to need dialysis after discharge (18%) than those with bacterial pneumonia (3%).
Researchers determined that patients with COVID-19-associated AKI had an increased risk of 148% for developing CKD after AKI compared with patients who had bacterial pneumonia.
“Our study shows that critically ill mechanically intubated COVID pneumonia patients had higher likelihood and risk of progression from AKI to CKD,” Edding told Healio. “As clinicians, this translates to closely monitoring our patients’ renal function when we see them outpatient — on top of evaluation for other long-term COVID symptoms. Also, this goes to show that there might be additional pathophysiology of the COVID virus to the kidneys that make them sicker.”
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Edding S. et al. Poster 5. Presented at: National Kidney Foundation Spring Clinical Meetings; April 5-10, 2022; Boston.
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