Prevalence, associated factors, and prognosis of acute kidney injury in critically ill patients with COVID-19 in sub-Saharan Africa: A retrospective single-center study.

Introduction: Acute kidney injury (AKI) constitutes a complication frequently encountered in patients with severe forms of COVID-19. The aim of this study was to evaluate the prevalence of acute kidney injury and to describe its associated factors.

Materials and methods: This was a retrospective, descriptive, analytical study over a period of 18 months at Dalal Jamm Hospital in Dakar. We included all patients admitted to the intensive care unit for the treatment of COVID-19. AKI was defined according to KDIGO 2012.

Results: During the study period, we collected 170 files. The mean age was 59.38 ± 14.81 years, and 40.6% were women. Hypertension and diabetes mellitus were the most frequently found comorbidities, respectively, in 37.65% and 31.18% of cases. AKI was present in 50 (29.4%) patients. Acute tubular injury was found in 44% of cases. Hemodialysis was performed in 10% of cases, and the indications were hyperkalemia (100%), and uremic encephalopathy (40%). Death occurred in 62.36% of cases. Recovery of renal function during hospitalization was noted in 16% of patients. In multivariable analysis, the factors associated with AKI were obesity (p = 0.020; adjusted odds ratio (aOR) = 7.406; 95% CI = 2.25 - 37.11) and non-renal Sequential Organ Failure Assessment (SOFA) (p = 0.001; aOR = 5.851; 95% CI = 3.04 - 11.2). AKI was an independently associated factor with death (p = 0.002; aOR = 4.510; 95% CI = 2.51 - 9.52).

Conclusion: AKI is common during COVID-19. AKI is correlated with the severity of the disease and the presence of comorbidities. AKI is independently associated with increased risk of death in COVID-19.