Twenty-four-hour serum creatinine variation is associated with poor outcome in the novel coronavirus disease 2019 (COVID-19) patients
Kidney Research and Clinical Practice 2021³â 40±Ç 2È£ p.231 ~ p.240
(Alfano Gaetano) - University of Modena and Reggio Emilia Section of Nephrology
(Ferrari Annachiara) - University of Modena and Reggio Emilia Section of Nephrology
(Fontana Francesco) - University Hospital of Modena Nephrology Dialysis and Transplant Unit
(Mori Giacomo) - University Hospital of Modena Nephrology Dialysis and Transplant Unit
(Ligabue Giulia) - University of Modena and Reggio Emilia Section of Nephrology
(Giovanella Silvia) - University of Modena and Reggio Emilia Section of Nephrology
(Magistroni Riccardo) - University of Modena and Reggio Emilia Section of Nephrology
(Meschiari Marianna) - University Hospital of Modena Clinic of Infectious Diseases
(Franceschini Erica) - University Hospital of Modena Clinic of Infectious Diseases
(Menozzi Marianna) - University Hospital of Modena Clinic of Infectious Diseases
Abstract
Background: The prognostic value of within-day sCr variation serum creatinine variation is unknown in the setting of the novel coronavirus disease 2019 (COVID-19). We evaluated the prognostic significance of 24-hour serum creatinine variation in COVID-19 patients.
Methods: A monocentric retrospective analysis was conducted in COVID-19 patients not admitted to the intensive care unit. Three groups were subdivided based on 24 hours serum creatinine variation from admission. In the stable kidney function group, 24-hour serum creatinine variation ranged from +0.05 to -0.05 mg/dL; in the decreased kidney function group, 24-hour serum creatinine variation was >0.05 mg/dL; in the improved kidney function group, 24-hour serum creatinine variation was <-0.05 mg/dL.
Results: The study population included 224 patients with a median age of 66.5 years and a predominance of males (72.3%). Within 24 hours of admission, renal function remained stable in 37.1% of the subjects, whereas it displayed improved and deteriorated patterns in 45.5% and 17.4%, respectively. Patients with decreased kidney function were older and had more severe COVID-19 symptoms than patients with stable or improved kidney function. About half of patients with decreased kidney function developed an episode of acute kidney injury (AKI) during hospitalization. Decreased kidney function was significantly associated with AKI during hospitalization (hazard ratio [HR], 4.6; 95% confidence interval [CI], 1.9-10.8; p < 0.001) and was an independent risk factor for 30-day in-hospital mortality (HR, 5.5; 95% CI, 1.1-28; p = 0.037).
Conclusion: COVID-19 patients with decreased kidney function within 24 hours of admission were at high risk of AKI and 30-day in-hospital mortality.
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Acute kidney injury, Biomarkers, Coronavirus, Kidney, Creatinine, Mortality
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COVID-19 patients with decreased kidney function within 24 hours of admission were at high risk of AKI and 30-day in-hospital mortality.