Adults who survive COVID-19-AKI may have fewer major adverse kidney events
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Key takeaways:
- Patients with COVID-19-associated AKI had a 33% lower risk for major adverse kidney events.
- Patients also had a 22% lower risk for worsened kidney function.
Adults who survive COVID-AKI hospitalization may experience fewer major adverse kidney events and lower mortality than patients with AKI tied to with other illnesses, according to published data.
“AKI is frequently experienced by patients hospitalized for COVID-19,” Abinet M. Aklilu, MD, MPH, of the department of internal medicine at Yale University School of Medicine in New Haven, Connecticut, wrote with colleagues. “AKI has been reported in more than one-fifth of COVID-19 hospitalizations, twice as often in patients requiring treatment in the [ICU] and has been associated with approximately 10% dialysis requirement and high mortality.”
In a multicenter cohort study of 9,624 hospitalized patients with AKI and COVID-19 or other ailments, researchers used electronic health records to examine long-term kidney outcomes. The retrospective longitudinal trial included patients hospitalized between March 2020 and June 2022 who were screened for SARS-CoV-2, had AKI and survived through discharge. Overall, 987 patients had COVID-AKI, 276 had influenza-associated AKI and 8,361 had AKI associated with other illnesses.
The study also included patients hospitalized from October 2016 to January 2020 and had influenza, AKI and survived through discharge.
Primary outcome was MAKE, defined as a composite of mortality and an eGFR decline of at least 25% from discharge or kidney failure requiring dialysis. Patients were followed for up to 2 years. Data were analyzed from December 2022 to November 2023.
Researchers found patients with COVID-19-associated AKI had a 33% lower risk of MAKE, including a 22% lower risk for worsened kidney function and a 69% lower risk for mortality compared with patients with AKI due to other illnesses.
Compared with other groups, patients with COVID-AKI were younger, had a higher baseline eGFR and worse comorbidity scores, higher illness severity, and longer hospital stays.
The study finding “are reassuring because, despite their seemingly higher overall post-discharge eGFR decline compared with AKI associated with influenza or other illnesses, COVID-AKI survivors experienced a rapid attenuation of their kidney function decline rate and had overall lower rates of long-term kidney progression,” the researchers wrote. “Replication in broader cohorts as well as assessment of the effects of other kidney dysfunction markers (eg, proteinuria) and the association of COVID-19specific therapeutics with kidney function trajectory are worth investigating in future studies.”
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