Acute kidney injury in the time of COVID-19.

Details

• Personal Author:
  Chan L ; Coca SG
• Description:
  Respiratory Disease, Respiratory Failure, and Ventilator Shortages - Those were the concerns in late February and early March, shortly before the surge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) hit the United States. By late March, not only were intensive care unit beds full and respiratory failure rampant in some major cities in the United States, but there was a new enemy lurking. The tsunami started to hit. It was not volume depletion-induced serum creatinine elevations. It was severe AKI with multiple electrolyte derangements. Troops were summoned and dialysis nurses worked around the clock to try to provide clearance to patients all over hospitals. Four-hour dialysis treatments were a thing of the past; 2 hours sometimes had to suffice. While President Trump enacted the Defense Production Act to force companies to make more ventilators, kidneys and life-sustaining dialysis machines were the forgotten resources. How did this happen? By the beginning of June, over 6.9 million patients had been diagnosed worldwide and more than 400,000 people had died. However, the early reports from China noted a relatively low incidence of AKI, some as low as 0.5%, with most studies reporting cumulative incidence in the single digits to the teens. Thus, the United States was not expecting an onslaught with regard to kidney disease. Now that the initial wave of the pandemic has passed, five studies from centers in the United States have come out documenting a much higher proportion (19%-43%) of AKI in hospitalized patients with COVID-19. One of the United States-based studies documented experiences with AKI of hospitalized patients with COVID-19 at the Ochsner Health System in New Orleans. The overall incidence of AKI in this cohort was 28%, which aligns with the other United States-based reports. Over one half of patients with AKI required acute dialysis; 98% of these patients received sustained low efficiency dialysis, and only two patients never required prolonged intermittent renal replacement therapy or continuous renal replacement therapy. These findings highlight how truly sick patients with COVID-19 were. ... Clinical investigators can take this summer reprieve and build up the infrastructure and data pipelines to try to inform the nephrology community, and the population at large, about the full landscape of COVID-19 kidney disease. We owe it to humanity to be better prepared against this devastating viral pandemic. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Occupational Health Safety Urine
• Keywords:
  Kidney disorders; Kidneys; Kidney function; Urinalysis; COVID-19; SARS-CoV-2; Coronavirus
• ISSN:
  2641-7650
• 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
• Volume:
  1
• Issue:
  7
• NIOSHTIC Number:
  nn:20064954
• Citation:
  Kidney360 2020 Jul; 1(7):588-590
• Contact Point Address:
  Lili Chan or Steven Coca, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1243, New York, NY 10029
• Email:
  Lili.chan@mountsinai.org
• Federal Fiscal Year:
  2020
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  False
• Start Date:
  20170701
• Source Full Name:
  Kidney360
• End Date:
  20200630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:54a8a83eb5274d547ff8cbe10de3f5323daf4abd83efbe129702812550718c367c4e9c4ba75a2e551804df0fdcc3e9d77279d7916011b0569cabebeb528d5520
• Download URL:
  https://stacks.cdc.gov/view/cdc/248626/cdc_248626_DS1.pdf
• File Type:
  [PDF - 513.26 KB ]