By Dr Hina Iftikhar, Dr Seema Alaee, Dr Jessica Bennett, Dr Rachel Kaminski, Dr David Windsor, Dr Charlie Sharp

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Background and Problem

Acute Kidney Injury (AKI) is associated with increased mortality and morbidity in COVID-19 patients.1-3 

It is hypothesised to be worse in patients with underlying Chronic Kidney Disease (CKD).

The aetiology of AKI in these patients is multifactorial with direct cytopathic effects on kidney tissue, involvement of angiotensin-converting enzyme 2 and immune mediated coagulopathy being responsible.2 

Although some studies have shown an association between kidney involvement and poor outcome in COVID-19, information on this subject remains limited.1-3 

We evaluated the prevalence of AKI in a subgroup of patients with COVID-19 and the associated mortality.


This was a prospective cohort study of 130 patients with COVID-19 admitted to Respiratory high dependency or Intensive care (HDU/ITU) settings.

Renal dysfunction, respiratory support with invasive mechanical ventilation (IMV) or non-invasive ventilation with continuous positive airway pressure (CPAP) and mortality were the clinical parameters


28.4% of patients were female with median age of 60 years (range 22-88 years).

33% (n=43) of patients were diagnosed with AKI on admission with 16% (n=7) of these known to have underlying CKD (Figure 1).

One patient had a previous renal transplant.

6% of patients had hypertension and 3% patients were known diabetics.

Overall mortality was 15.5% (n=20) in patients with AKI on admission, the majority 18% (n=13) seen in the CPAP cohort likely attributable to underlying CKD 10% (n=7) (Table 1).