Manifestations of kidney involvement in COVID-19 patients and progression to chronic kidney disease
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616.6-02:[616.98:578.834.1] (1)
Patologia sistemului urogenital. Boli urinare şi sexuale (genitale) (392)
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RĂZLOG, Tatiana, RUSSU, Eugen, ALEXA, Zinaida, CEBAN, Emil, GROZA, Costina, GROPPA, Liliana. Manifestations of kidney involvement in COVID-19 patients and progression to chronic kidney disease. In: Revista de Ştiinţe ale Sănătăţii din Moldova, 2024, vol. 11, nr. 1, pp. 11-18. ISSN 2345-1467. DOI: https://doi.org/10.52645/MJHS.2024.1.02
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Revista de Ştiinţe ale Sănătăţii din Moldova
Volumul 11, Numărul 1 / 2024 / ISSN 2345-1467

Manifestations of kidney involvement in COVID-19 patients and progression to chronic kidney disease

DOI:https://doi.org/10.52645/MJHS.2024.1.02
CZU: 616.6-02:[616.98:578.834.1]

Pag. 11-18

Răzlog Tatiana12, Russu Eugen21, Alexa Zinaida1, Ceban Emil2, Groza Costina21, Groppa Liliana12
 
1 Timofei Moșneaga Republican Clinical Hospital,
2 ”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
 
Disponibil în IBN: 3 aprilie 2024


Rezumat

Introduction. COVID-19 was initially considered a predominantly respiratory infection, with mortality associated with progression of respiratory failure, but currently is recognized as a multisystem disease with a wide range of manifestations. One of the most common complications of COVID-19 is acute kidney injury (AKI), which predominantly evolved to chronic kidney disease (CKD). The objective of the study was to investigate the types of acute kidney injury and their prognostic value in hospitalized patients with COVID-19 with evolution to chronic kidney disease. Material and methods. The study utilized a comprehensive database of patients admitted to general department of COVID-19 at Timofei Moșneaga Republican Clinical Hospital from 2020 to 2022 years (in total 1000 patients). The first part of the study was a retrospective study, focusing on patients with confirmed COVID-19 and lung injury was diagnosed by computer tomography. The second part was a prospective study assessing the prognostic value of inflammatory markers, renal functional status and kidney injury. Results. AKI occurs in 29.6% of patients with COVID-19. The risk of AKI and CKD is higher in patients with more comorbidities, a more severe course of disease, elevated levels of ASAT/ALAT > 1.6 and hematuria at admission, which significantly increases the risk of progression to CKD. Patients with a history of CKD, and who had ASAT > 40 U/L, ASAT/ALAT > 1.6 and hematuria, experience the onset of AKI before hospitalization. Independent negative predictors of hospital-developed AKI include hypertension, Charlson Comorbidity Index > 4 points, respiratory failure, ASAT/ALAT > 1.6, D-dimers > 250 ng/ml, and hematuria. Hospital mortality in patients with COVID-19 was 20.8%, compared to 8.5% in patients without AKI, and this rate increased to 50% when AKI developed (p < 0.001). Conclusions. Patients who developed AKI during admission had a higher incidence of negative outcomes compared to those with AKI prior to admission. Independent predictors of in-hospital mortality in COVID-19 patients were increased serum CRP. Death in hospitalized patients with COVID-19 and AKI was independently associated with factors such as age > 75 years, history of CKD, admission to Intensive Care Unit, leukocytosis, and ASAT/ALAT > 1.6.

Cuvinte-cheie
chronic kidney disease, acute kidney injury, COVID-19.