Researchers at Northwell Health, a hospital in Great Neck, New York, collected data on patients hospitalized with COVID-19 to analyze associated risk factors and outcomes—specifically related to acute kidney injury (AKI). Their findings, which were published in Kidney International, show over one third of patients hospitalized with COVID-19 developed AKI, of which 14.3% needed dialysis.*

Background information

While COVID-19 is primarily a respiratory disease, the kidneys and other organs are often affected, too. AKI is when there is sudden damage to the kidneys or kidney failure that occurs in just a few hours or days—which often happens when someone is hospitalized or in the ICU. The causes of AKI are typically:

• a decrease in blood flow to the kidneys, 
• direct damage to the kidneys as a result of a different disease and/or condition, and/or 
• a blockage in the urinary tract.

Research and investigation details

The team of physicians and researchers reviewed and summarized the health records of every adult patient (18 years of age or older) who was hospitalized with COVID-19 between March 1, 2020, and April 5, 2020, at 13 different academic and community hospitals in the New York metropolitan area. 

Results and conclusions

Of the 5,449 patients studied, 1,993 patients (36.6%) developed AKI, and 14.3% of those 1,993 patients needed renal replacement therapy (RRT), or dialysis. 

The researchers obtained the following information:

• AKI was primarily detected in COVID-19 patients with respiratory failure. 
• Of patients who required ventilation and developed AKI, more than half had AKI onset within 24 hours of intubation.
• Important risk factors for AKI development that were identified are “older age, diabetes, cardiovascular disease, black race, hypertension, and need for ventilation and vasopressor medications.”
• Among patients with AKI, 684 (35%) died, 519 (26%) were discharged, and 780 (39%) were still in the hospital.

In addition, severe AKI occurred most frequently at the time of intubation or mechanical ventilation, and AKI was diagnosed in almost 90% of patients on ventilators.

The study concluded that AKI occurs more frequently among patients with COVID-19; that it occurs early and in association with respiratory failure; and is associated with a poor prognosis.

Additional information can be found on Medical Dialogues in Dr. Kamal Kant Kohli’s article, called “Over One Third Of Patients Hospitalized With Covid-19 May Develop AKI.”

*Hirsch, J.S.; Ng, J.H.; Ross, D.W.; Sharma, P. et al (2020). “Acute kidney injury in patients hospitalized with COVID-19.”