Acute kidney injury in patients with COVID-19 (May 2020)
Acute kidney injury
in patients with COVID-19 (May 2020)
AKI has been reported
among ptns infected with the coronavirus disease
2019 (COVID-19),
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 37 %, with 14 % of cases were in need for dialysis (DX). Almost 50% 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 90 % of ptns requiring mechanical
ventilation and in 22 % 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.
Effect of sodium bicarbonate
on post-contrast acute kidney injury among patients receiving
intravenous contrast (April 2020)
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 intravenous sodium bicarbonate.
These findings support the recommendation that volume expansion should be NOT
administered to prevent post-contrast AKI in ptns with
an eGFR ≥30 mL/min/1.73 m2.
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