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 ORIGINAL ARTICLE
Year : 2022  |  Volume : 32  |  Issue : 4  |  Page : 348-358

Correlation of AKI with risk factors, ventilatory support, renal replacement therapy in a cohort of COVID-19 patients


1 Department of Nephrology, MGM Healthcare, Chennai, Tamil Nadu, India
2 Department of Internal Medicine, MGM Healthcare, Chennai, Tamil Nadu, India
3 Department of Radiology, MGM Healthcare, Chennai, Tamil Nadu, India
4 Department of Microbiology, MGM Healthcare, Chennai, Tamil Nadu, India
5 Department of Nephrology; Department of Internal Medicine, MGM Healthcare, Chennai, Tamil Nadu, India
6 Department of Statistical Analysis, MGM Healthcare, Chennai, Tamil Nadu, India

Correspondence Address:
Georgi Abraham
MGM Healthcare, No 54, Nelson Manickam Road, Aminjikarai, Chennai - 600 029, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijn.ijn_350_21

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Introduction: There is a scarcity of information on the incidence and outcomes of acute kidney injury (AKI) in COVID-19 patients in India. Therefore, we analyzed the correlation of AKI risk factors, ventilatory support, and renal replacement therapy and compared the outcomes of first and second COVID-19 waves in this tertiary care center. Methods: We retrospectively analyzed the patients' medical records with a positive RT-PCR for COVID-19 between July 2020 and May 2021. We looked at the clinical outcomes of the first and second COVID-19 waves and documented the frequency, risk factors for AKI, and the relationship between AKI and in-hospital mortality. Univariate and multivariate binomial logistic regression yielded odds ratios for the risk variables of AKI. Risk differences and age-adjusted odds ratios, as well as 99.5% confidence intervals, were used to compare COVID-19 outcomes between the first and second waves. Results: Of the 1260 hospitalized patients with COVID-19, 86 (6.8%) presented with AKI and 8 (0.7%) patients required dialysis. The most common comorbidity was diabetes mellitus (55.2%), hypertension (42.1%), hypothyroidism (11.3%), and coronary artery disease (8.1%). A total of 229 (18.17%) patients were admitted to ICU, 574 (45.5%) received ventilation, and 26 (2.0%) required mechanical ventilation. The incidence of in-hospital death in the patients with AKI as per the stage from 1 to 3 was 9 (15.8%), 7 (35%), and 5 (55.6%), respectively. Compared to the first wave, the second wave cohort had a lower risk of AKI (adj OR: 0.426; CI: 0.232–0.782) and mortality (adj OR: 0.252; CI: 0.090–0.707). Conclusions: In our study, AKI prevalence was 6.8%, the need for ventilation was 45.5%, ECMO 0.2%, and the mortality rate 2.9%. Second wave of COVID-19 exhibits improved clinical outcomes compared to the first wave.






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