Introduction
Although there are reports of development of acute kidney injury (AKI) as a common presentation among patients hospitalized due to coronavirus disease 19 (COVID-19) from different parts of the world, there is paucity of data among Nepalese population. So, this study was conducted to describe the incidence, severity, risk factors, and outcomes associated with AKI in the setting of hospitalization of COVID-19 in a tertiary hospital in central part of Nepal.
Methods
This prospective observational study was done among the patients admitted at Chitwan Medical College Teaching hospital, a 750-beded tertiary hospital in central Nepal. Patients who were diagnosed to have COVID-19 by RT-PCR were the population of the study. Those patients who were already on maintenance dialysis or denied or were unable to give consent were excluded from the study. Acute kidney injury was defined as per KDIGO guideline. Descriptive analysis was done to describe frequency of AKI, requirement of dialysis, renal recovery and mortality.
Results
Among 213 patients admitted with COVID-19 during the study period, 190 patients could be included in the study. AKI occurred in 70 (36.84%) patients among which 10 (14.28%) patients required dialysis. The proportions with stages 1, 2, or 3 AKI were 42%, 28% and 30% respectively. Of all patients, 40 (21%) patients required admission to intensive care of which 30 (75%) experienced AKI. Urinalysis among the patients with AKI showed proteinuria (79%), hematuria (74%) and pyuria (39%). Independent predictors of severe AKI were underlying chronic kidney disease (CKD), male sex, older age and presence of shock requiring inotropic support at admission. In-hospital mortality was 52% among patients with AKI versus 6% among those without AKI (OR, 8.2; 95% confidence interval, 6.3 to 11.5).
Conclusions
AKI is common among Nepalese patients hospitalized with COVID-19 and is associated with high mortality.
No conflict of interest