Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19

This study aimed to assess kidney function and its significance for the development of in-hospital complications in patients hospitalized with acute cardiovascular pathology infected with COVID-19. Methods. This prospective cohort single-center study included 139 patients with acute cardiovascul...

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Main Authors: Y. Lutai, O. Parkhomenko, O. Irkin, D. Khomyakov
Format: Article
Language:English
Published: State Institution «Institute of Nephrology NAMS of Ukraine" 2023-01-01
Series:Український Журнал Нефрології та Діалізу
Subjects:
Online Access:https://ukrjnd.com.ua/index.php/journal/article/view/705
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author Y. Lutai
O. Parkhomenko
O. Irkin
D. Khomyakov
author_facet Y. Lutai
O. Parkhomenko
O. Irkin
D. Khomyakov
author_sort Y. Lutai
collection DOAJ
description This study aimed to assess kidney function and its significance for the development of in-hospital complications in patients hospitalized with acute cardiovascular pathology infected with COVID-19. Methods. This prospective cohort single-center study included 139 patients with acute cardiovascular pathology diagnosed with COVID-19. Sixty-nine (49.6%) patients had acute coronary syndrome (47 with acute myocardial infarction (AMI), 33 (23.7%) patients had hypertension, 24 (17.3%) patients had acute decompensated heart failure, 9 (6.5%) patients had tachysystolic paroxysms of atrial fibrillation, 2 (1.4%) patients had an acute pulmonary embolism, and 2 (1.4%) patients had syncope. The mean age was 67.9±12.7 years, and 70 (50.4%) patients were male. Arterial hypertension was present in 87.1% of patients, diabetes mellitus in 20.9%, congestive heart failure in 30.9%, chronic obstructive pulmonary disease in 9.4%, AMI in 20.1%, and ischemic stroke in 9.4%. Results. The initial creatinine level was 110.7±66.1 μmol/l and eGFR (CKD-EPI) was 63.3±20.3 ml/min/1.73m2 (eGFR<60 ml/min/1.73m2 was diagnosed in 46.0% of the patients). The patients with eGFR<60 ml/min/1.73m2 were older, more often female, frequently had a history of atrial fibrillation, had lower hemoglobin and blood pressure on admission, a greater number of complications (need for noninvasive ventilation, inotropic therapy), and higher in-hospital mortality (25.0% vs. 5.3 %, p=0.002). Acute kidney injury, which was evaluated according to KDIGO criteria (increase in creatinine level ≥ 26.5 μmol/l within 48 hours or ≥ 1.5 times within 7 days) was observed in 21 (15.4%) patients (12.0% in patients with eGFR≥60 ml/min/1.73m2 and 18.8% with eGFR<60 ml/min/1.73m2, p<0.05). These patients did not differ significantly in basic clinical and anamnestic data from patients without AKI but had lower spO2 on admission (86.9±11.2% vs. 93.4±5.0%, p=0.016). Patients with AKI had a significantly higher number of in-hospital complications: acute hypoxic delirium (47.6% vs. 8.7%, p=0.003), venous thromboembolism (14.3% vs. 0.9%, p=0.070), death from all causes (47.6% vs. 7.0%, p=0.002) and more often required organ supportive therapy: non-invasive/invasive pulmonary ventilation (52.4% vs. 11.3%, p<0.001), inotropic therapy (57.1% versus 5.2%, p<0.001). Using the simplified criterion of AKI, the category of patients at high risk for hospital complications and death could also be distinguished (37.9% vs. 8.2%, p=0.004). Vaccination against COVID-19 (at least 2 weeks before hospitalization prevented the development of AKI (16.5% vs. 5.0%, p=0.046) and tended to prevent in-hospital mortality (15.7% vs. 5.0%, p=0.076). Conclusions. Renal dysfunction in patients with acute cardiovascular pathology infected with COVID-19 is associated with in-hospital complications and can be prevented by prophylactic vaccination.
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spelling doaj.art-869ab426f4d546519b4f625516f006042024-03-14T16:53:47ZengState Institution «Institute of Nephrology NAMS of Ukraine"Український Журнал Нефрології та Діалізу2304-02382616-73522023-01-011(77)10.31450/ukrjnd.1(77).2023.04Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19Y. Lutai0O. Parkhomenko1O. Irkin2D. Khomyakov3State Institution "National Scientific Center "Institute of Cardiology, Clinical and Regenerative Medicine named after Academician M.D. Strazheskо of the National Academy of Medical Sciences of Ukraine"State Institution "National Scientific Center "Institute of Cardiology, Clinical and Regenerative Medicine named after Academician M.D. Strazheskо of the National Academy of Medical Sciences of Ukraine"State Institution "National Scientific Center "Institute of Cardiology, Clinical and Regenerative Medicine named after Academician M.D. Strazheskо of the National Academy of Medical Sciences of Ukraine"State Institution "National Scientific Center "Institute of Cardiology, Clinical and Regenerative Medicine named after Academician M.D. Strazheskо of the National Academy of Medical Sciences of Ukraine" This study aimed to assess kidney function and its significance for the development of in-hospital complications in patients hospitalized with acute cardiovascular pathology infected with COVID-19. Methods. This prospective cohort single-center study included 139 patients with acute cardiovascular pathology diagnosed with COVID-19. Sixty-nine (49.6%) patients had acute coronary syndrome (47 with acute myocardial infarction (AMI), 33 (23.7%) patients had hypertension, 24 (17.3%) patients had acute decompensated heart failure, 9 (6.5%) patients had tachysystolic paroxysms of atrial fibrillation, 2 (1.4%) patients had an acute pulmonary embolism, and 2 (1.4%) patients had syncope. The mean age was 67.9±12.7 years, and 70 (50.4%) patients were male. Arterial hypertension was present in 87.1% of patients, diabetes mellitus in 20.9%, congestive heart failure in 30.9%, chronic obstructive pulmonary disease in 9.4%, AMI in 20.1%, and ischemic stroke in 9.4%. Results. The initial creatinine level was 110.7±66.1 μmol/l and eGFR (CKD-EPI) was 63.3±20.3 ml/min/1.73m2 (eGFR<60 ml/min/1.73m2 was diagnosed in 46.0% of the patients). The patients with eGFR<60 ml/min/1.73m2 were older, more often female, frequently had a history of atrial fibrillation, had lower hemoglobin and blood pressure on admission, a greater number of complications (need for noninvasive ventilation, inotropic therapy), and higher in-hospital mortality (25.0% vs. 5.3 %, p=0.002). Acute kidney injury, which was evaluated according to KDIGO criteria (increase in creatinine level ≥ 26.5 μmol/l within 48 hours or ≥ 1.5 times within 7 days) was observed in 21 (15.4%) patients (12.0% in patients with eGFR≥60 ml/min/1.73m2 and 18.8% with eGFR<60 ml/min/1.73m2, p<0.05). These patients did not differ significantly in basic clinical and anamnestic data from patients without AKI but had lower spO2 on admission (86.9±11.2% vs. 93.4±5.0%, p=0.016). Patients with AKI had a significantly higher number of in-hospital complications: acute hypoxic delirium (47.6% vs. 8.7%, p=0.003), venous thromboembolism (14.3% vs. 0.9%, p=0.070), death from all causes (47.6% vs. 7.0%, p=0.002) and more often required organ supportive therapy: non-invasive/invasive pulmonary ventilation (52.4% vs. 11.3%, p<0.001), inotropic therapy (57.1% versus 5.2%, p<0.001). Using the simplified criterion of AKI, the category of patients at high risk for hospital complications and death could also be distinguished (37.9% vs. 8.2%, p=0.004). Vaccination against COVID-19 (at least 2 weeks before hospitalization prevented the development of AKI (16.5% vs. 5.0%, p=0.046) and tended to prevent in-hospital mortality (15.7% vs. 5.0%, p=0.076). Conclusions. Renal dysfunction in patients with acute cardiovascular pathology infected with COVID-19 is associated with in-hospital complications and can be prevented by prophylactic vaccination. https://ukrjnd.com.ua/index.php/journal/article/view/705СOVID-19, acute kidney injury, chronic kidney disease, acute cardiovascular pathology, vaccination.
spellingShingle Y. Lutai
O. Parkhomenko
O. Irkin
D. Khomyakov
Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19
Український Журнал Нефрології та Діалізу
СOVID-19, acute kidney injury, chronic kidney disease, acute cardiovascular pathology, vaccination.
title Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19
title_full Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19
title_fullStr Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19
title_full_unstemmed Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19
title_short Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19
title_sort kidney dysfunction and in hospital complications in patients with acute cardiovascular pathology infected with covid 19
topic СOVID-19, acute kidney injury, chronic kidney disease, acute cardiovascular pathology, vaccination.
url https://ukrjnd.com.ua/index.php/journal/article/view/705
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AT oirkin kidneydysfunctionandinhospitalcomplicationsinpatientswithacutecardiovascularpathologyinfectedwithcovid19
AT dkhomyakov kidneydysfunctionandinhospitalcomplicationsinpatientswithacutecardiovascularpathologyinfectedwithcovid19