Palomba H, Cubos D, Bozza F, Zampieri FG, Romano TG. Development of a Risk Score for AKI onset in COVID-19 Patients: COV-AKI Score.
BMC Nephrol 2023;
24:46. [PMID:
36859175 PMCID:
PMC9977632 DOI:
10.1186/s12882-023-03095-4]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
PURPOSE
Acute Kidney Injury (AKI) in COVID-19 patients is associated with increased morbidity and mortality. In the present study, we aimed to develop a prognostic score to predict AKI development in these patients.
MATERIALS AND METHODS
This was a retrospective observational study of 2334 COVID 19 patients admitted to 23 different hospitals in Brazil, between January 10th and August 30rd, 2020. The primary outcome of AKI was defined as any increase in serum creatinine (SCr) by 0.3 mg/dL within 48 h or a change in SCr by ≥ 1.5 times of baseline within 1 week, based on Kidney Disease Improving Global Outcomes (KDIGO) guidelines. All patients aged ≥ 18 y/o admitted with confirmed SARS-COV-2 infection were included. Discrimination of variables was calculated by the Receiver Operator Characteristic Curve (ROC curve) utilizing area under curve. Some continuous variables were categorized through ROC curve. The cutoff points were calculated using the value with the best sensitivity and specificity.
RESULTS
A total of 1131 patients with COVID-19 admitted to the ICU were included. Patients mean age was 52 ± 15,8 y/o., with a prevalence of males 60% (n = 678). The risk of AKI was 33% (n = 376), 78% (n = 293) of which did not require dialysis. Overall mortality was 11% (n = 127), while for AKI patients, mortality rate was 21% (n = 80). Variables selected for the logistic regression model and inclusion in the final prognostic score were the following: age, diabetes, ACEis, ARBs, chronic kidney disease and hypertension.
CONCLUSION
AKI development in COVID 19 patients is accurately predicted by common clinical variables, allowing early interventions to attenuate the impact of AKI in these patients.
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