الفهرس 
ACUTE KIDNEY INJURY (AKI)Only 14 pages are availabe for public view
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Abstract
T
his was a prospective study that was held in KOBRY ALKOBBA military complex to evaluate the prognosis of COVID-19 patients with Acute kidney injury (AKI).
Evaluation of AKI in hospitalized patients with COVID-19, which included adult patients with laboratory and radiologically confirmed SARS-COV-2 infection admitted to ward and ICU patients at KOBRY ALKOBBA military complex, Cairo, Egypt.
Incidence of AKI according to KDIGO criteria in patients with COVID-19 infection during 3 months were followed up during their hospital stay and after discharge from hospital for 3 months to know the outcome of AKI and the outcome of COVID-19 infection.
Our study shows that mean age of study population was 55.4, 51.3% of patients were male and 48.8% were female.
Co-morbidities in our study shows that 50% of study population had DM, 43.8% had HTN,32.5% had IHD,25%had COPD,38.8% had Bronchial asthma and 30% had CKD.
The main clinical presentation in our study was fever in 87.5% of patients, Headache in 63.8% of patients and Cough in 63.8% of patients.
Onset of symptoms was acute in 65% of patients.
Treatment protocols in our study shows that 76.3 % of patients received Redmisver,17.5 % of patients received low dose corticosteroid,51.3% received moderate of corticosteroid and 31.3% of patients received high dose of corticosteroid. 27.5% of patients need mechanical ventilation.
In our study, comparison was done between creatinine and urea level at baseline, after 1 month and after 3 months,this comparison shows that creatinine and urea level decreased significantly in comparison to baseline.
Our study shows that Median time of AKI occurrence was 3(2-4)days after admission,13.8% of patients were at stage I AKI,31.2% were at stage II AKI and 55% of patients were at stage III AKI.
Our study shows that 42 patients needed haemodialysis, 40 patients needed IHD and 2 patients needed CRRT.
The median number of haemodialysis sessions were 7 (4-10) sessions.
Our study shows that CT-chest findings, 33.8% were CO-RADS 3, 13.8% were CO-RADS 4 and 52.5% were CO-RADS 5.60 (75.0%).
For the Prognosis of covid our study shows that, 53.8% of patients died, 42.5% were cured, and 3.8% were cured on oxygen therapy(home o2).
For the Prognosis of AKI our study shows that, 25.0% were totally recovered, 21.2% were CKD and 53.8% of patients died.
Our study shows that mean age is higher in stage III AKI in comparison to Stage II and Stage I AKI. And also age was higher in stage II in comparison to stage I AKI.
Our study shows that number of Diabetic patients were higher in stage III AKI in comparison to Stage I and Stage II AKI. Number of Hypertensive patients were higher in Stage III AKI in comparison to Stage I and stage II AKI. Number of IHD patients was higher in Stage III AKI in comparison to Stage I and Stage II AKI. Number of COPD patients were higher in stage III AKI in comparison to Stage I and Stage II AKI.
Our study shows that number of patients received redmisver were higher in stage III and stage II AKI in comparison to stage I AKI.
Number of patients received high dose corticosteroids were higher in stage III AKI in comparison to stage I and stage II AKI.
Regarding mechanical ventilation our study shows that patients needed mechanical ventilation were higher in stage III AKI in comparison to stage I and stage II AKI.
Our study shows that there is improvement in creatinine and urea level after 3 months in comparison to creatinine and urea level after 1 month in different stages of AKI.
Our study shows that Median time of AKI occurrence delayed in stage III AKI in comparison to stage I, II AKI and Number of patients needing dialysis is higher in stage III AKI in comparison to stage I and stage II AKI.
Our study shows that ICU admission is higher in stage III AKI in comparison to Stage I and Stage II AKI.
Regarding prognosis of covid our study shows that 93.2% of patients died in stage III AKI, 8% of patients died in stage II AKI, 4.5 % of patients cured in stage III AKI, 84% cured in stage II AKI, 100% of patients cured in stage I AKI, 2.3% of patients cured with o2 therapy in stage III AKI, 8% in stage II AKI.
Regarding prognosis of AKI our study shows that 93.2% of patients Died in Stage III AKI, 8% died in stage II AKI, 100 % of patients were totally recovered in stage I AKI, 36% in stage II AKI. In stage III AKI 6.8% of patients become CKD, 56% in stage II AKI.
CONCLUSION AND RECOMMENDATION
I
ncidence of AKI in our study was 9.19% in all patients admitted in ICU and ward during 3 months. Incidence of AKI in patient admitted in ICU was 11.7% during 3 months. Incidence of AKI in patient admitted in ward was 5.5% during 3 months. Our findings suggest that COVID-19 cases, particularly those in ICU, should be closely monitored for the progression of AKI.
Early detection of AKI and prompt meditation may improve COVID-19 patient’s outcomes.
The occurrence of AKI is a poor prognostic factor in SARS-CoV-2 infected patients. The mortality rate in COVID-19 patients complicated with AKI group is very high.