ArticleJournal of nephrology2025
Acute kidney injury in the pandemic years revisited: distinct patterns of staging and recovery in patients with and without COVID-19.
Article in Journal of nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcute kidney injury (AKI) is a frequent and severe complication in COVID-19 patients, associated with poor outcomes. This study evaluates the characteristics and outcomes of AKI in COVID-19-positive versus negative patients during the pandemic in an emerging country, emphasizing differences in incidence, recovery, and healthcare resource utilization.
methodsWe conducted a retrospective cohort study including 9112 intensive care unit (ICU) patients from two major hospitals in Brazil, hospitalized between March 2020 and April 2022. Statistical analyses included logistic regression, Kaplan-Meier survival analysis, and time series analysis of AKI trends across COVID-19 waves.
results2333 patients (25.6%) tested positive for COVID-19. AKI incidence (79.7% vs. 52.6%, p < 0.001) and severity (Stage 3: 48.6% vs. 26.6%, p < 0.001) were significantly higher in the COVID-19-positive group. COVID-19 patients with AKI had longer ICU stays (median 11 vs. four days, p < 0.001) and higher mechanical ventilation needs (57.9% vs. 31.1%, p < 0.001). COVID-19 independently increased the risk of AKI (OR 2.03, CI 1.77-2.32); the coexistence of COVID-19 and AKI conferred significantly higher odds for mortality (OR 8.53, CI 6.67-11.02). Kidney recovery was less frequent in COVID-19 patients, with a higher incidence of acute kidney disease in survivors (OR 1.99, CI 1.74-2.28). Sensitivity analysis of septic patients confirmed higher AKI incidence and mortality in COVID-19 patients.
conclusionCOVID-19 significantly affects AKI incidence, severity, and recovery, particularly in resource-limited settings. These findings emphasize the need for targeted strategies to manage kidney complications during pandemics and stress the importance of healthcare system preparedness in emerging countries.
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