Acute kidney injury in COVID-19: A single-center experience in Nigeria

Abstract

Background & objective: Despite available data from developed countries, suggesting a high incidence of acute kidney injury (AKI) in coronavirus disease 2019 (COVID-19), there is scarce data from African countries, including Nigeria. We conducted this study to determine and document the incidence, the associated factors and the outcome (in-hospital mortality) of AKI among COVID-19 patients managed in a center in Nigeria. Methodology: It was a retrospective review of confirmed COVID-19 cases managed at a center in Nigeria. AKI was defined using 2012 Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria. We extracted relevant data from the electronic records of the COVID-19 patients admitted to our hospital and analyzed. Fischer's exact tests were used to test factors associated with AKI for discrete variables, Mann-Whitney U test was used for skewed continuous data, and T-test for continuous normal distribution variables. Results: This study involved 41 of the 56 confirmed COVID-19 cases. The mean age was 45 +/- 17.94 y. A majority of the patients were males (33;80.5%). AKI occurred in 6 (14.6%) of the patients. Of the 6 AKI;4 (66.7%) and 2 (33.3%) were in stages 1 and 3 respectively. One patient (16.7%) had had hemodialysis. Of the 6 with AKI, 3 died with a mortality rate of 50.0%. Factors associated with AKI included age above 45 years, body weakness, severe and critical COVID, urea > 10 mmol/l, and serum creatinine > 1.5 mg/dl. Only severe and critical disease was predictive of AKI (adjusted odds ratio 1.777, 95% CI 1.028, 3.074). Conclusion: The results of our study show that AKI is common in severe and critical COVID-19 and is associated with a poor outcome.