The Association of Standard Kt/V and Surface Area-Normalized Standard Kt/V with Clinical Outcomes in Hemodialysis Patients

Details

• Personal Author:
  Chan L ; Chaudhary K ; Chauhan K ; Coca SG ; El Shamy O ; Nadkarni GN ; Pattharanitima P ; Sharma S ; Uribarri J
• Description:
  Background: Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associated with worse outcomes. However, AKI among hospitalized patients with COVID-19 in the United States is not well described. Methods: This retrospective, observational study involved a review of data from electronic health records of patients aged >/=18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality. Results: Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patients with AKI required dialysis. The proportions with stages 1, 2, or 3 AKI were 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% had leukocyturia. Independent predictors of severe AKI were CKD, men, and higher serum potassium at admission. In-hospital mortality was 50% among patients with AKI versus 8% among those without AKI (aOR, 9.2; 95% confidence interval, 7.5 to 11.3). Of survivors with AKI who were discharged, 35% had not recovered to baseline kidney function by the time of discharge. An additional 28 of 77 (36%) patients who had not recovered kidney function at discharge did so on posthospital follow-up. Conclusions: AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Of all patients with AKI, only 30% survived with recovery of kidney function by the time of discharge. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Hematologic Diseases Mortality Occupational Health Safety
• Keywords:
  Anemia Author Keywords: Adequacy Of Dialysis Cohort Studies Kidney Disorders Kidneys Medical Treatment Mortality Rates Nephrological Disorders Nutrition Survival
• ISSN:
  1492-7535
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  495-505
• Volume:
  24
• Issue:
  4
• NIOSHTIC Number:
  nn:20062575
• Citation:
  Hemodial Int 2020 Oct; 24(4):495-505
• Contact Point Address:
  Lili Chan, MD, MS, Division of Nephrology, Department of Medicine Icahn School of Medicine at Mount Sinai One Gustave L Levy Place, Box 1243 New York, NY 10029, USA
• Email:
  lili.chan@mountsinai.org
• Federal Fiscal Year:
  2021
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  False
• Start Date:
  20170701
• Source Full Name:
  Hemodialysis International
• End Date:
  20200630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:29a837999543ad4d1738f58352091073f429bc6ab2eb2b2d906edb01c47ea36255c809b5273607372c091c59871d1a020883dc016d89c24c1575a2860a35dff3
• Download URL:
  https://stacks.cdc.gov/view/cdc/225790/cdc_225790_DS1.pdf
• File Type:
  [PDF - 1.15 MB ]