TORNA ALL’ELENCO

ACUTE KIDNEY INJURY (AKI) IS ASSOCIATED WITH INCREASED IN-HOSPITAL MORTALITY AND WITH IMPAIRMENT OF RENAL, LUNG, MOTOR AND IMMUNE FUNCTION 1 YEAR AFTER DISCHARGE FOR COVID-19 in Nephrology Dialysis Transplantation

2022
ASL Vercelli

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (10)Vedi tutti...

Morosini U
Translational Medicine, University of Eastern Piedmont, Vercelli, Italy
Marengo M
ASL CN 1, Cuneo, Italy
Prenna S
Translational Medicine, University of Eastern Piedmont, Vercelli, Italy

et alii...

Abstract

BACKGROUND AND AIMS: AKI is the most frequent complication after respiratory failure in COVID-19. AKI increases mortality risk, length of hospital stay and healthcare costs, with possible progression towards CKD. Study aims: (1) evaluation of AKI incidence in 1020 COVID-19 hospitalized patients; (2) comparison of AKI incidence in COVID-19 versus pre-pandemic period; (3) establishment of out-patient follow-up for monitoring kidney, lung, motor and immune function; (4) creation of a biobank for biomarker discovery studies. METHOD: AKI incidence was calculated matching laboratory and administrative data of 26 214 hospitalized patients in 2018-2019 and in 1020 COVID-19 patients in 2020-2021: KDIGO algorithms were applied for AKI grading. After 12 months from discharge, 232 COVID AKI patients and relative controls matched for age and gender were evaluated for kidney (eGFR, biomarkers of tubular damage NGAL, CCl- 14, DKK-3), lung (DLCO, CT scan) and neuro-motor (SPPB, 2-min walking test, post-traumatic stress test-IES) function. RESULTS: Before the pandemic, in-hospital AKI incidence was 18% (10% KDIGO 1, 5% KDIGO 2, 3% KDIGO 3): median age of AKI patients was 69. In-hospital mortality was 3.5% in non-AKI group versus 15% in AKI group in accordance with KDIGO stages. In COVID patients, AKI incidence increased to 37% (20% KDIGO 1.11% KDIGO 2, 6% KDIGO 3): median age of patients was 54. In-hospital mortality was 31% in the AKI group; AKI is an independent risk factor for death. After 12 months from hospital discharge, COVID AKI patients showed a persistent reduction of respiratory function (severe DLCO impairment < 60%) related to the extent of CT scan abnormalities. AKI patients also presented the motor function impairment and a worse post-traumatic stress response. GFR reduction was 1.8 mL/min in non-AKI patients versus 9.7 mL/min in AKI COVID patients not related to age. Urinary DKK-3 and CCL-14 were also higher in the AKI group. Last, IgG response after SARS-CoV-

DOI : 10.1093/ndt/gfac068.039

Keywords

biological marker; endogenous compound; immunoglobulin G; acute kidney failure; adult; algorithm; antibody response; biobank; conference abstract; controlled study; coronavirus disease 2019; diffusing capacity for carbon monoxide; estimated glomerular filtration rate; female; follow up; gender; glomerulus filtration rate; hospital discharge; hospital patient; hospitalization; human; in-hospital mortality; incidence; kidney disease; lung function; major clinical study; male; middle aged; mortality; motoneuron; motor dysfunction; motor performance; neuromuscular function; nonhuman; outpatient; pandemic; posttraumatic stress disorder; respiratory function; risk factor; Severe acute respiratory syndrome coronavirus 2; vaccination; walk test; x-ray computed tomography;