Risk Factors Associated with Acute Kidney Injury in a Cohort of Hospitalized Patients with COVID-19

Abstract Background: Patients with COVID-19 have a high incidence of acute kidney injury (AKI), which is associated with mortality. The objective of the study was to determine the factors associated with AKI in patients with COVID-19. Methodology: A retrospective cohort was established in two university hospitals in Bogotá, Colombia. Adults hospitalized for more than 48 hours from March 6, 2020, to March 31, 2021, with confirmed COVID-19 were included. The main outcome was the incidence of AKI during the 28 days following hospital admission. Results: A total of 1584 patients were included: 60.4% were men, 738 (46.5%) developed AKI, 23.6% were classified as KDIGO 3, and 11.1% had renal replacement therapy. The risk factors for developing AKI during hospitalization were male sex (OR 2.27, 95% CI 1.73-2.99), age older than 65 years (1.02, 1.01-1.03), HTN (OR 6.16, 1.98-19.2), the use of vancomycin (1.59, 1.06-2.39), piperacillin/tazobactam (OR 1.65, 1.19-2.28), and vasopressor support (2.36, 1.51-3.69). The gross hospital mortality for AKI was 45.5% versus 11.7% without AKI. Conclusions: This cohort showed that male sex, age, history of hypertension and chronic kidney disease (CKD), presentation with elevated qSOFA, in-hospital use of nephrotoxic drugs and the requirement for vasopressor support were the main risk factors for developing AKI in patients hospitalized for COVID-19.