Detection of Incidence and Outcomes of Acute Kidney Injury in Patients with COVID-19, Admitted to Cairo University Hospitals

Abstract

Background: COVID-19-associated acute kidney injury (AKI) is a severe complication with high mortality, linked to direct viral entry, inflammation and thrombosis. Diagnosis follows kidney disease Improving Global Outcomes (KDIGO) criteria, and no specific treatment exists.

Objectives: To determine the incidence and outcomes of AKI in COVID-19 patients.

Methods: This cross-sectional study included 661 confirmed COVID-19 patients. AKI was diagnosed using the KDIGO criteria. The incidence of AKI was calculated, and patients were categorized into AKI and non-AKI groups. Subgroup analyses were performed based on AKI severity (Stages 1–3), COVID-19 severity (mild, moderate, severe), comorbidities, and treatment strategies.

Results: AKI was detected in 168 patients (25.4%). AKI patients were older (57.17 ± 14.30 vs. 43.90 ± 13.48 years, p < 0.001) and predominantly male (70.2% vs. 50.3%, p < 0.001). Comorbidities such as diabetes (28.6% vs. 14.0%, p < 0.001), hypertension (53.6% vs. 19.7%, p < 0.001), and chronic kidney disease (41.7% vs. 1.0%, p < 0.001) were significantly associated with AKI. Severe COVID-19 was more frequent in the AKI group (35.7% vs. 4.7%, p < 0.001). ICU admission (51.2% vs. 8.9%, p < 0.001) and assisted ventilation (53.6% vs. 8.1%, p < 0.001) were significantly higher in AKI patients. Mortality was markedly increased in the AKI group (15.5% vs. 0.6%, p < 0.001).

Conclusions: AKI is a common and severe complication in hospitalized COVID-19 patients, particularly among older males with comorbidities. It is associated with higher ICU admission, ventilatory support, and mortality.