Effect of Electrolyte Imbalance on Mortality and Late Acute Kidney Injury in Hospitalized COVID-19 Patients.

IF 0.8 4区医学 Q4 UROLOGY & NEPHROLOGY

Iranian journal of kidney diseases Pub Date : 2022-07-01

Tahereh Sabaghian, Mohamadjavad Honarvar, Seyed Amir Ahmad Safavi-Naini, Arefe Sadat Sadeghi Fadaki, Mohamad Amin Pourhoseingholi, Hamidreza Hatamabadi

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引用次数: 0

Abstract

Introduction: As a multisystem illness, Coronavirus disease 2019 (COVID-19) can damage different organs. This study investigated the effect of electrolyte imbalance (EI), with or without concomitant renal dysfunction, on the prognosis of COVID-19 in hospitalized patients.

Methods: We evaluated 499 hospitalized patients with confirmed COVID-19, without a history of chronic kidney disease. The patients' demographic data, laboratory values, and outcomes were retrospectively collected from the hospital information system. Serumelectrolytes including sodium, potassium, magnesium, calcium, and phosphorus abnormalities were analyzed on admission and during the hospitalization period. The outcomes of this study were the occurrence of acute kidney injury (AKI) after the first week of hospitalization and in-hospital mortality rate. Multivariate analyses were carried out to obtain the independent risk of each EI on mortality, by adjusting for age, gender, and AKI occurrence.

Results: Among the 499 COVID-19 patients (60.9% male), AKI occurred in 168 (33.7%) and mortality in 92 (18.4%) cases. Hypocalcemia (38%) and hyponatremia (22.6%) were the most prevalent EIs, and all EIs were more common in the AKI group than in the non-AKI group. Hyponatremia (Adjusted Odds ratio [AOR] = 2.34, 95% CI: 1.30 to 4.18), hypernatremia (AOR = 8.52, 95% CI: 1.95 to 37.32), and hyperkalemia (AOR = 4.63, 95% CI: 1.65 to 13) on admission were associated with poor prognosis. Moreover, hyponatremia (AOR = 3.02, 95% CI: 1.28 to 7.15) and hyperphosphatemia (AOR = 5.12, 95% CI: 1.24 to 21.09) on admission were associated with late AKI occurrence.

Conclusion: This study highlights the role of hyponatremia, hypernatremia, hyperkalemia, and hyperphosphatemia in poor prognosis of COVID-19. According to the independent effect of EI on late AKI and mortality, we recommend physicians to raise awareness to closely monitor and correct EI during hospitalization. DOI: 10.52547/ijkd.6904.

本刊更多论文

电解质失衡对COVID-19住院患者死亡率和晚期急性肾损伤的影响

2019冠状病毒病(COVID-19)是一种多系统疾病，可损害不同器官。本研究探讨电解质失衡(EI)伴或不伴肾功能不全对住院患者COVID-19预后的影响。方法:对499例无慢性肾脏疾病史的确诊COVID-19住院患者进行评估。从医院信息系统中回顾性收集患者的人口统计数据、实验室值和结果。在入院时和住院期间分析钠、钾、镁、钙、磷等血清电解质异常。本研究的结果是住院第一周后急性肾损伤(AKI)的发生率和住院死亡率。通过调整年龄、性别和AKI发生情况，进行多变量分析以获得每种EI对死亡率的独立风险。结果:499例新冠肺炎患者中，男性占60.9%，发生AKI 168例(33.7%)，死亡92例(18.4%)。低钙血症(38%)和低钠血症(22.6%)是最常见的ei，所有ei在AKI组中比在非AKI组中更常见。入院时低钠血症(校正优势比[AOR] = 2.34, 95% CI: 1.30 ~ 4.18)、高钠血症(AOR = 8.52, 95% CI: 1.95 ~ 37.32)和高钾血症(AOR = 4.63, 95% CI: 1.65 ~ 13)与预后不良相关。此外，入院时低钠血症(AOR = 3.02, 95% CI: 1.28 ~ 7.15)和高磷血症(AOR = 5.12, 95% CI: 1.24 ~ 21.09)与晚期AKI发生相关。结论:本研究强调了低钠血症、高钠血症、高钾血症和高磷血症在COVID-19不良预后中的作用。鉴于EI对晚期AKI和死亡率的独立影响，我们建议医生在住院期间提高意识，密切监测和纠正EI。DOI: 10.52547 / ijkd.6904。

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来源期刊

Iranian journal of kidney diseases UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The Iranian Journal of Kidney Diseases (IJKD), a peer-reviewed journal in English, is the official publication of the Iranian Society of Nephrology. The aim of the IJKD is the worldwide reflection of the knowledge produced by the scientists and clinicians in nephrology. Published quarterly, the IJKD provides a new platform for advancement of the field. The journal’s objective is to serve as a focal point for debates and exchange of knowledge and experience among researchers in a global context. Original papers, case reports, and invited reviews on all aspects of the kidney diseases, hypertension, dialysis, and transplantation will be covered by the IJKD. Research on the basic science, clinical practice, and socio-economics of renal health are all welcomed by the editors of the journal.