Observational studyAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2021
The Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study.
Observational study in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Global geographic and socioeconomic disparities in COVID-associated acute kidney injury: a systematic review and meta-analysis.Journal of global health · 2025Pooled it
- Acute kidney injury outcomes in covid-19 patients: systematic review and meta-analysis.Jornal brasileiro de nefrologiaPooled it
- Levels of circulating kidney injury markers and IL-10 identify non-critically ill patients with COVID-19 at risk of death.JCI insight · 2026Trial
- Positive fluid balance is associated with earlier acute kidney injury in COVID-19 patients.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Article
- Review
- The risk of kidney disease increases following SARS-CoV-2 infection compared to influenza.Communications medicine · 2026Article
- Early Changes in Renal Function as Predictors of In-Hospital Mortality in COVID-19 Patients.Life (Basel, Switzerland) · 2026Article
- RECOVID: Retrospective Observational Study of Renal Outcomes and Long-Term Mortality in Patients With COVID-19-Associated AKI, A Comparison Between Vaccinated and Unvaccinated Patients.Kidney medicine · 2025Article
- COVID-19 and Diabetes: Persistent Cardiovascular and Renal Risks in the Post-Pandemic Landscape.Life (Basel, Switzerland) · 2025Review
- Acute kidney injury in the pandemic years revisited: distinct patterns of staging and recovery in patients with and without COVID-19.Journal of nephrology · 2025Article
- Investigation of renal function in patients with long COVID in the Amazon region: a cross-sectional study.BMC infectious diseases · 2025Observational
- Article
- Metagenomic Next-Generation Sequencing-Assisted Risk Prediction and Stratification of Infections After Kidney Transplantation: A Case Study of COVID-19.Infection and drug resistance · 2025Article
- Kidney Function Decline After COVID-19 Infection.JAMA network open · 2024Article
- Promoting Collaborative Scholarship During the COVID-19 Pandemic Through an Innovative COVID-19 Data Explorer and Repository at Yale School of Medicine: Development and Usability Study.JMIR formative research · 2024Article
- Differentiation of Prior SARS-CoV-2 Infection and Postacute Sequelae by Standard Clinical Laboratory Measurements in the RECOVER Cohort.Annals of internal medicine · 2024Observational
- Impact of COVID-19 Vaccination on Mortality and Clinical Outcomes in Hemodialysis Patients.Vaccines · 2024Article
- SARS-CoV-2 PCR cycle threshold value at admission might not be a good predictor of in-hospital COVID-19-associated AKI.Journal of general and family medicine · 2024Article
- Comparative analysis of six nutritional scores in predicting prognosis of COVID-19 patients.Frontiers in nutrition · 2024Article
- The Time-Varying Impact of COVID-19 on the Acute Kidney Disorders: A Historical Matched Cohort Study and Mendelian Randomization Analysis.Health data science · 2024Article
Corrections and comments
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Authors and funding
20 authors at 2 institutions in 1 country.
Funding
Abstract
RATIONALE &
objectiveAlthough coronavirus disease 2019 (COVID-19) has been associated with acute kidney injury (AKI), it is unclear whether this association is independent of traditional risk factors such as hypotension, nephrotoxin exposure, and inflammation. We tested the independent association of COVID-19 with AKI. STUDY
designMulticenter, observational, cohort study. SETTING &
participantsPatients admitted to 1 of 6 hospitals within the Yale New Haven Health System between March 10, 2020, and August 31, 2020, with results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing via polymerase chain reaction of a nasopharyngeal sample. EXPOSURE: Positive test for SARS-CoV-2. OUTCOME: AKI by KDIGO (Kidney Disease: Improving Global Outcomes) criteria. ANALYTICAL APPROACH: Evaluated the association of COVID-19 with AKI after controlling for time-invariant factors at admission (eg, demographic characteristics, comorbidities) and time-varying factors updated continuously during hospitalization (eg, vital signs, medications, laboratory results, respiratory failure) using time-updated Cox proportional hazard models.
resultsOf the 22,122 patients hospitalized, 2,600 tested positive and 19,522 tested negative for SARS-CoV-2. Compared with patients who tested negative, patients with COVID-19 had more AKI (30.6% vs 18.2%; absolute risk difference, 12.5% [95% CI, 10.6%-14.3%]) and dialysis-requiring AKI (8.5% vs 3.6%) and lower rates of recovery from AKI (58% vs 69.8%). Compared with patients without COVID-19, patients with COVID-19 had higher inflammatory marker levels (C-reactive protein, ferritin) and greater use of vasopressors and diuretic agents. Compared with patients without COVID-19, patients with COVID-19 had a higher rate of AKI in univariable analysis (hazard ratio, 1.84 [95% CI, 1.73-1.95]). In a fully adjusted model controlling for demographic variables, comorbidities, vital signs, medications, and laboratory results, COVID-19 remained associated with a high rate of AKI (adjusted hazard ratio, 1.40 [95% CI, 1.29-1.53]). LIMITATIONS: Possibility of residual confounding.
conclusionsCOVID-19 is associated with high rates of AKI not fully explained by adjustment for known risk factors. This suggests the presence of mechanisms of AKI not accounted for in this analysis, which may include a direct effect of COVID-19 on the kidney or other unmeasured mediators. Future studies should evaluate the possible unique pathways by which COVID-19 may cause AKI.
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