EVALUATION OF AKI AND POST-ILLNESS RENAL IMPAIRMENT IN COVID-19: COMPARISON WITH BACTERIAL PNEUMONIA AND INFLUENZA INFECTIONS.

 

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EVALUATION OF AKI AND POST-ILLNESS RENAL IMPAIRMENT IN COVID-19: COMPARISON WITH BACTERIAL PNEUMONIA AND INFLUENZA INFECTIONS.

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Kenta
Taito
Kenta Taito taitokenta2000@yahoo.co.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan *
Masatoshi Oka masatoshi_oka@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Hikaru Sugimoto sugimoto.hikaru14@gmail.com Graduate School of Medicine, The University of Tokyo Biochemistry and Molecular Biology Tokyo Japan -
Haruto Fukagawa haruto_fukagawa@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Kaoruko Fukushima kaoruko_fukushima@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Kanako Yatabe kanako_yatabe@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Ayano Izawa ayano_izawa@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Yui Ota yui_ota@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Takaaki Tsuchiya takaaki_tsuchiya@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Shiho Matsuno shiho_matsuno@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Noriko Yamanaka noriko_yamanaka@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Wako Yumura wako_yumura@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Noriyuki Suzuki noriyuki_suzuki@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Mitsuyo Itabashi mitsuyo_itabashi@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -
Takashi Takei takashi_takei@tmghig.jp Tokyo Metropolitan Institute for Geriatrics and Gerontology Nephrology and Dialysis Tokyo Japan -

Acute kidney injury (AKI) has garnered attention as it is frequently observed in COVID-19 and is associated with severe disease. Furthermore, in recent years, reduced renal function has been identified as a long-term sequela following COVID-19. However, some reports indicate that AKI caused by COVID-19 results in milder long-term renal impairment compared to other causes of AKI, suggesting it may merely represent the progression from AKI to chronic kidney disease (CKD). The objective of this study is to evaluate the incidence of AKI and the subsequent decline in renal function following infection with COVID-19, bacterial pneumonia, and influenza, and to investigate the differences between these conditions.

We conducted a retrospective study of COVID-19 patients hospitalized at our institution from March 2020 to September 2022, bacterial pneumonia patients hospitalized during the same period, and influenza infection patients hospitalized from January 2016 to December 2019. Renal function was followed for 2 years after discharge. We compared the incidence of AKI, rate of renal function decline, and prognostic factors among the three disease groups.

During the study period, 929 cases of COVID-19 (mean age 67.1 years), 761 cases of bacterial pneumonia (mean age 84.6 years), and 265 cases of influenza infection (mean age 83.4 years) were hospitalized. Follow-up of renal function after discharge was possible for 276, 369, and 185 cases, respectively. The incidence rates of AKI at admission were 12.2%, 38.5%, and 14.3%, respectively. The changes in eGFR over two years were -2.2 mL/min/1.73m²/year, +4.7 mL/min/1.73m²/year, and -1.8 mL/min/1.73m²/year, respectively.

It has been revealed that AKI occurs during hospitalization not only for COVID-19 but also for bacterial pneumonia and influenza infections. Factors such as age and underlying conditions are thought to influence the incidence rate of AKI and subsequent changes in renal function. This report incorporates statistical analysis and a review of the literature.

Kewords