Utilisation of a national database to characterise renal function in patients with COVID19 infection

Abstract

Rationale

The incidence of renal function alterations among patients with COVID19 is unknown.

Objective

To determine the incidence of acute kidney injury (AKI) or augmented renal clearance (ARC) in patients hospitalised with COVID19 and identify risk factors for patients who may exhibit each renal alteration.

Methods

Retrospective, observational cohort analysis of hospitalise, adult patients within the National COVID Cohort Collaborative (N3C) database with laboratory confirmed COVID19 and available data to calculate creatinine clearance using the Cockcroft–Gault equation from 1 January 2020 through 9 April 2022.

Measurements

Incidence of AKI or ARC and patient demographics.

Main results

15 608 patients were included for renal function characterisation where 20.9% experienced AKI and 34.8% exhibited ARC. ARC lasted longer than AKI; however, AKI was associated with increased hospital length of stay and mortality. 11 274 patients were included in logistic regression analysis. Height and White race were the only variables associated with decreased risk of AKI while male sex and diabetes were associated with increased risk. Male sex, Black race and hypertension were associated with decreased risk of ARC. Age was associated with decreased risk of both AKI and ARC while weight and Hispanic ethnicity were associated with increased risk in both renal alterations.

Conclusions

A significant proportion of patients exhibit renal alterations during their hospitalisation for COVID19. These results provide initial evidence of identifying patients at risk of AKI or ARC, but more research is needed, especially with respect to use of biomarkers for renal alteration risk stratification.