High incidence and early onset of acute kidney injury in adults hospitalized with moderate-to-severe coronavirus disease 2019: a prospective cohort analysis
1
Clinic Medicine Department, School of Medicine of the University of São Paulo, São Paulo, Brazil
2
Cardiopneumology Department, School of Medicine of the University of São Paulo, São Paulo, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A94
ABSTRACT
BACKGROUND:
Acute kidney injury is a frequent complication of severe coronavirus disease 2019 (COVID-19). We estimated the incidence and timing of acute kidney injury during hospitalization using creatinine-based Kidney Disease: Improving Global Outcomes criteria.
METHODS:
Prospective cohort of adults hospitalized with moderate-to-severe COVID-19 in 2020 at Hospital das Clínicas, São Paulo, Brazil. Serial serum creatinine measurements during admission were used to identify acute kidney injury, defined as: (1) an increase ≥0.3 mg/dL within 48 hours and/or (2) an increase ≥1.5-fold within 7 days. We calculated overall incidence, incidence by criterion, time to acute kidney injury, and overlap between criteria.
RESULTS:
Among 3,009 hospitalized patients, 2,957 had serial serum creatinine measurements. Acute kidney injury (any criterion) occurred in 1,588 patients (53.7%). Median time to acute kidney injury was 3 days (interquartile range 1–6), with a mean of 4.8 days. Criterion (1) was met by 1,439 patients (48.7%) and criterion (2) by 1,403 (47.4%). Both criteria were met by 1,254 patients (42.4%), while 185 (6.3%) met only criterion (1) and 149 (5.0%) met only criterion (2). No acute kidney injury occurred in 1,369 patients (46.3%).
CONCLUSIONS:
Acute kidney injury affected more than half of adults hospitalized with moderate-to-severe COVID-19 and occurred early during admission. These findings support early kidney monitoring and may aid risk stratification for subsequent kidney impairment.
Acute kidney injury is a frequent complication of severe coronavirus disease 2019 (COVID-19). We estimated the incidence and timing of acute kidney injury during hospitalization using creatinine-based Kidney Disease: Improving Global Outcomes criteria.
METHODS:
Prospective cohort of adults hospitalized with moderate-to-severe COVID-19 in 2020 at Hospital das Clínicas, São Paulo, Brazil. Serial serum creatinine measurements during admission were used to identify acute kidney injury, defined as: (1) an increase ≥0.3 mg/dL within 48 hours and/or (2) an increase ≥1.5-fold within 7 days. We calculated overall incidence, incidence by criterion, time to acute kidney injury, and overlap between criteria.
RESULTS:
Among 3,009 hospitalized patients, 2,957 had serial serum creatinine measurements. Acute kidney injury (any criterion) occurred in 1,588 patients (53.7%). Median time to acute kidney injury was 3 days (interquartile range 1–6), with a mean of 4.8 days. Criterion (1) was met by 1,439 patients (48.7%) and criterion (2) by 1,403 (47.4%). Both criteria were met by 1,254 patients (42.4%), while 185 (6.3%) met only criterion (1) and 149 (5.0%) met only criterion (2). No acute kidney injury occurred in 1,369 patients (46.3%).
CONCLUSIONS:
Acute kidney injury affected more than half of adults hospitalized with moderate-to-severe COVID-19 and occurred early during admission. These findings support early kidney monitoring and may aid risk stratification for subsequent kidney impairment.
| eISSN: | 2654-1459 |
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