Acute kidney injury in patients with COVID-19 (May 2020)
AKI has been reported
among ptns infected with the coronavirus disease
but the available database on its current incidence and its clinical criteria
have been limited owing to the small number of patients. In an observational report
conducting 5500 patients who admitted with COVID-19 infection, AKI occurred mostly in %, with % of cases were in need for dialysis (DX). Almost % of the ptns with AKI presents with hematuria and proteinuria
syndrome, and about one1/3rd were diagnosed with AKI within
24 hs of hospital admission. AKI has been observed in % of ptns requiring mechanical
ventilation and in % of non-ventilated
ptns. The current findings raise the postulation that AKI is a common sequela of COVID-19,
furthermore, it can be recognized
as an important marker of clinical disease severity.
Ptns with an estimated
glomerular filtration rate (eGFR)
of <30 mL/min/1.73 m2 have a higher risk
of acute kidney injury (AKI)
following intravenous iodinated contrast used
for computed tomography (CT).
By contrast, the risk is not appreciably increased among ptns with a higher
eGFR, consequently, it is NOT recommended to apply the policy of prophylactic volume expansion in such cohort of ptns. In a trial conducting
over 550 ptns with mild/ moderate chronic kidney disease (eGFR ≥30 mL/min/1.73 m2) who underwent CT with IV contrast, post-contrast AKI can be
observed at similar rates among cohorts receiving, and not receiving prophylactic volume expansion with .
These findings support the recommendation that should be NOT
administered to prevent post-contrast AKI in ptns with
an eGFR ≥30 mL/min/1.73 m2.
Kooiman J, Sijpkens YWJ, et al. Effect of No Prehydration vs Sodium Bicarbonate
Prehydration Prior to Contrast-Enhanced Computed Tomography in the Prevention
of Postcontrast Acute Kidney Injury in Adults With Chronic Kidney Disease: The
Kompas Randomized Clinical Trial. JAMA Intern Med 2020; 180:533.