SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution
Posted on 2022-02-11 - 04:23
Abstract Background Hospitalized patients with SARS-CoV2 develop acute kidney injury (AKI) frequently, yet gaps remain in understanding why adults seem to have higher rates compared to children. Our objectives were to evaluate the epidemiology of SARS-CoV2-related AKI across the age spectrum and determine if known risk factors such as illness severity contribute to its pattern. Methods Secondary analysis of ongoing prospective international cohort registry. AKI was defined by KDIGO-creatinine only criteria. Log-linear, logistic and generalized estimating equations assessed odds ratios (OR), risk differences (RD), and 95% confidence intervals (CIs) for AKI and mortality adjusting for sex, pre-existing comorbidities, race/ethnicity, illness severity, and clustering within centers. Sensitivity analyses assessed different baseline creatinine estimators. Results Overall, among 6874 hospitalized patients, 39.6% (n = 2719) developed AKI. There was a bimodal distribution of AKI by age with peaks in older age (≥60 years) and middle childhood (5–15 years), which persisted despite controlling for illness severity, pre-existing comorbidities, or different baseline creatinine estimators. For example, the adjusted OR of developing AKI among hospitalized patients with SARS-CoV2 was 2.74 (95% CI 1.66–4.56) for 10–15-year-olds compared to 30–35-year-olds and similarly was 2.31 (95% CI 1.71–3.12) for 70–75-year-olds, while adjusted OR dropped to 1.39 (95% CI 0.97–2.00) for 40–45-year-olds compared to 30–35-year-olds. Conclusions SARS-CoV2-related AKI is common with a bimodal age distribution that is not fully explained by known risk factors or confounders. As the pandemic turns to disproportionately impacting younger individuals, this deserves further investigation as the presence of AKI and SARS-CoV2 infection increases hospital mortality risk.
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Bjornstad, Erica C.; Cutter, Gary; Guru, Pramod; Menon, Shina; Aldana, Isabella; House, Scott; et al. (2022). SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.5837431.v1
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AUTHORS (26)
EB
Erica C. Bjornstad
GC
Gary Cutter
PG
Pramod Guru
SM
Shina Menon
IA
Isabella Aldana
SH
Scott House
NM
Nancy M. Tofil
CS
Catherine A. St. Hill
YT
Yasir Tarabichi
VB
Valerie M. Banner-Goodspeed
AC
Amy B. Christie
SM
Surapaneni Krishna Mohan
DS
Devang Sanghavi
JM
Jarrod M. Mosier
GV
Girish Vadgaonkar
AW
Allan J. Walkey
RK
Rahul Kashyap
VK
Vishakha K. Kumar
VB
Vikas Bansal
KB
Karen Boman