Takeaway
- Chronic anticoagulation does not reduce the risk of acute kidney injury (AKI) and its severity, including the need for renal replacement therapy (RRT) in hospitalised patients with COVID-19.
Why this matters
- Findings suggest that renal microvascular thrombosis is unlikely to play a vital role in COVID-19-related AKI, which is more likely to be multifactorial, warranting early detection and management.
Study design
- A retrospective study reviewed electronic records of 1032 patients with COVID-19 (age, >18 years) who were admitted to Manchester University Foundation Trust Hospitals between 10 March and 30 April 2020.
- AKI was classified according to the Kidney Disease Improving Global Outcomes criteria.
- Funding: None.
Key results
- Of the 1032 patients, 164 (15.9%) received anticoagulant therapy prior to hospital admission.
- No significant difference was seen between patients who received anticoagulants and those who did not in:
- rates of AKI (23.8% vs 19.7%; P=.278);
- severity of AKI stage III (48.7% vs 42.7%; P=.783); and
- need for RRT (1.2% vs 3.5%; P=.204).
- In multivariate analysis, anticoagulation was not associated with AKI (OR, 1.02; 95% CI, 0.60-1.68; P=.952).
- Risk factors for AKI were (OR; 95% CI):
- pre-existing renal disease (2.31; 1.42-3.72; P=.001);
- hypertension (1.61; 1.07-2.46; P=.024); and
- male gender (1.65; 1.11-2.49; P=.015).
Limitations
- Retrospective.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
