ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation

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Clinical features and early diagnosis of  acute kidney injury in pationts with COVID-19

  

  • Online:2020-10-28 Published:2020-10-30

Abstract: Objective:To investigate the clinical features of novel coronavirus pneumonia complicated with acute kidney injury(AKI),and explore its risk identification and early diagnosis.Methodology:In this study,we enrolled the novel corona virus disease 2019(COVID19) patients who were diagnosed in Zhongshan Second People Hospital from January 2020 to March 2020.Demographic data,clinical data and laboratory test results were collected to establish the clinical database.According to the Kidney Disease Improving Global Outcomes (KDIGO) criterion,patients were divided into nonAKI group and AKI group.The differences between the two groups in clinical data and laboratory examination were comparedThe receiver operating characteristic(ROC) curve and the area under curve(AUC) were used to evaluate these indexes capability of detecting AKI.Results:61 Covid19 patients were enrolled in this study.The dynamic changes of serum creatinine were observed in the subjects,and the peak of serum creatinine[79(63,865)  μmol/L]was significantly higher than admission serum creatinine[66(56,75)  μmol/L]and discharge serum creatinine[68(59,82)  μmol/L],with statistically significant differences (P<005).The incidence of AKI was 131%,including 5 case (5/8) of AKI stage 1,1 case (1/8) of AKI stage 2,and 2 cases(2/8) of AKI stage 3.Elderly patients with essential diseases such as hypertension,diabetes and chronic kidney disease had a higher risk of AKI(P<005).The levels of admission urea nitrogen,admission serum creatinine,peak of serum creatinine and discharge serum creatinine were significantly higher in AKI group than those in nonAKI group(P<005).The AUC of admission urea nitrogen,admission serum creatinine and peak of serum creatinine predicted AKI in Covid19 patients were 0854(0740,0931),0830(0712,0914) and 0900(0796,0962),respectively.Compared with the nonAKI group,AKI group had higher renal replacement therapy rate(P<005) and longer hospitalization stay (P>005).Conclusion:COVID19 patients have a higher incidence of AKI.Elderly patients  with underlying disease were more likely to develop AKI,which affects clinical prognosis.Dynamic monitoring of kidney markers is helpful for risk identification and early diagnosis of AKI.