ArticleAnnals of intensive care2021
Acute kidney injury prevalence, progression and long-term outcomes in critically ill patients with COVID-19: a cohort study.
Article in Annals of intensive care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04445259 (Study of the Treatment and Outcomes in Critically Ill Patients With COVID-19 and High Risk of Acute Kidney Injury), which is not on this map. Cited by 53 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Study of the Treatment and Outcomes in Critically Ill Patients With COVID-19 and High Risk of Acute Kidney Injury
Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it, 114 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
- Long-term renal outcomes of patients with COVID-19: a meta-analysis of observational studies.Journal of nephrology · 2023Pooled it
- The global epidemiology of acute kidney injury: challenges and opportunities.Nature reviews. Nephrology · 2026Review
- Renal microthrombosis and thrombomodulin deficiency in COVID-19-associated acute kidney injury.BMC nephrology · 2026Observational
- The Renin Angiotensin System: Insights into the Role of ACE2 in Glomerular Injury Including SARS-CoV-2 Infection.International journal of molecular sciences · 2026Review
- Determination of Risk Factors, Incidence, and Mortality Rates of Acute Kidney Injury in COVID-19 Patients Hospitalized in the Intensive Care Unit.Journal of clinical medicine · 2026Article
- Article
- sFGL2 as a Potential Immunosuppressive Biomarker Associated With COVID-19 Severity in Kidney Transplant Recipients.Immunity, inflammation and disease · 2025Article
- Community-Acquired Acute Kidney Injury and Late Kidney Dysfunction in Survivors of COVID-19 Hospitalization.Kidney international reports · 2025Article
- Renal Long COVID: A Scoping Review.Kidney medicine · 2025Article
- Incidence of major adverse kidney events after ICU admission in COVID-19 and non-COVID-19 ARDS patients.BMJ open · 2025Article
- The Impact of Prior COVID-19 on Long-Term Mortality and Echocardiographic Predictors in Chronic Kidney Disease Patients.Diagnostics (Basel, Switzerland) · 2025Article
- The effects of urine alkalinization on kidney function in critically ill patients with COVID-19: a proof-of-concept randomized clinical trial.Intensive care medicine experimental · 2025Article
- Long term outcomes of patients with chronic kidney disease after COVID-19 in an urban population in the Bronx.Scientific reports · 2025Article
- Survival of critically ill people with COVID-19 and acute kidney injury undergoing hemodialysis in public and private hospitals in Joinville: a cohort study, 2020-2021.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2025Article
- Kidney damage associated with COVID-19: from the acute to the chronic phase.Renal failure · 2024Review
- Research on the global trends of COVID-19 associated acute kidney injury: a bibliometric analysis.Renal failure · 2024Review
- Acute Kidney Injury in the Context of COVID-19: An Analysis in Hospitalized Mexican Patients.Infectious disease reports · 2024Article
- Long-term outcome of COVID-19 patients with acute kidney injury requiring kidney replacement therapy.Journal of anesthesia, analgesia and critical care · 2024Article
- A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country.BMC nephrology · 2024Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are limited data on acute kidney injury (AKI) progression and long-term outcomes in critically ill patients with coronavirus disease-19 (COVID-19). We aimed to describe the prevalence and risk factors for development of AKI, its subsequent clinical course and AKI progression, as well as renal recovery or dialysis dependence and survival in this group of patients.
methodsThis was a retrospective observational study in an expanded tertiary care intensive care unit in London, United Kingdom. Critically ill patients admitted to ICU between 1st March 2020 and 31st July 2020 with confirmed SARS-COV2 infection were included. Analysis of baseline characteristics, organ support, COVID-19 associated therapies and their association with mortality and outcomes at 90 days was performed.
resultsOf 313 patients (70% male, mean age 54.5 ± 13.9 years), 240 (76.7%) developed AKI within 14 days after ICU admission: 63 (20.1%) stage 1, 41 (13.1%) stage 2, 136 (43.5%) stage 3. 113 (36.1%) patients presented with AKI on ICU admission. Progression to AKI stage 2/3 occurred in 36%. Risk factors for AKI progression were mechanical ventilation [HR (hazard ratio) 4.11; 95% confidence interval (CI) 1.61-10.49] and positive fluid balance [HR 1.21 (95% CI 1.11-1.31)], while steroid therapy was associated with a reduction in AKI progression (HR 0.73 [95% CI 0.55-0.97]). Kidney replacement therapy (KRT) was initiated in 31.9%. AKI patients had a higher 90-day mortality than non-AKI patients (34% vs. 14%; p < 0.001). Dialysis dependence was 5% at hospital discharge and 4% at 90 days. Renal recovery was identified in 81.6% of survivors at discharge and in 90.9% at 90 days. At 3 months, 16% of all AKI survivors had chronic kidney disease (CKD); among those without renal recovery, the CKD incidence was 44%.
conclusionsDuring the first COVID-19 wave, AKI was highly prevalent among severely ill COVID-19 patients with a third progressing to severe AKI requiring KRT. The risk of developing CKD was high. This study identifies factors modifying AKI progression, including a potentially protective effect of steroid therapy. Recognition of risk factors and monitoring of renal function post-discharge might help guide future practice and follow-up management strategies. Trial registration NCT04445259.
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