J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Review

Volume 12, Number 6, June 2020, pages 352-361

COVID-19 Pandemic Causing Acute Kidney Injury and Impact on Patients With Chronic Kidney Disease and Renal Transplantation

**Table 1.** Diagnosis of AKI Was Based on the KDIGO Classification
AKI staging	Serum creatinine	Urine output
AKI: acute kidney injury; KDIGO: Kidney Disease Improving Global Outcomes; RRT: renal replacement therapy.
Stage 1	Increase of more than or equal to 0.3 mg/dL (≥ 26.5 mmol/L) or increase to more than or equal to 150-200% (1.5- to 2-fold) from baseline	Less than 0.5 mL/kg/h for more than 6 h
Stage 2	Increased to more than 200-300% (2- to 3-fold) from baseline	Less than 0.5 mL/kg/h for more than 12 h
Stage 3	Increased to more than 300% (> 3-fold) from baseline, or more than or equal to 4.0 mg/dL (≥ 354 mmol/L) with an acute increase of at least 0.5 mg/dL (44 mmol/L) or on RRT	Less than 0.3 mL/kg/h for 24 h or anuria for 12 h

Table 1. Diagnosis of AKI Was Based on the KDIGO Classification

AKI staging

Serum creatinine

Urine output

AKI: acute kidney injury; KDIGO: Kidney Disease Improving Global Outcomes; RRT: renal replacement therapy.

Stage 1

Increase of more than or equal to 0.3 mg/dL (≥ 26.5 mmol/L) or increase to more than or equal to 150-200% (1.5- to 2-fold) from baseline

Less than 0.5 mL/kg/h for more than 6 h

Stage 2

Increased to more than 200-300% (2- to 3-fold) from baseline

Less than 0.5 mL/kg/h for more than 12 h

Stage 3

Increased to more than 300% (> 3-fold) from baseline, or more than or equal to 4.0 mg/dL (≥ 354 mmol/L) with an acute increase of at least 0.5 mg/dL (44 mmol/L) or on RRT

Less than 0.3 mL/kg/h for 24 h or anuria for 12 h

Table 2. Summary of Findings From Multiple Studies Including Patient Characteristics, Comorbidities, Incidence of AKI in General as Well as ICU/Severely Ill Patients, Number of Patients Requiring CRRT, ECMO and Mortality

Study/country

Related information

Median age in years

Males

Comorbid conditions, N (%)

AKI, N (%)

AKI ICU admission or severe disease, N (%)

CRRT, N (%)

ECMO, N (%)

Mortality, N (%)

CRRT: continuous renal replacement therapy; ECMO: extra corporeal membrane oxygenation; N: number of patients; AKI: acute kidney injury; ICU: intensive care unit; HTN: hypertension; DM: diabetes mellitus; CVD: cardiovascular disease; CKD: chronic kidney disease; ESRD: end-stage renal disease; T: total patients; I: ICU patients; S: patients with severe disease; NA: not available.

Wang et al, 2020 [26]/China

138

75 (54.3%)

HTN, 43 (31.2%)

5 (3.6%)

3 (8.3%)

2 (1.45%)/T

4 (2.9%)/T

6 (4.3%)

CVD, 20 (14.5%)

2 (5.5%)/I

4 (11.1%)/I

DM, 14 (10.1%)

CKD, 4 (2.9%)

Guan et al, 2020 [27]/China

1,099

637 (58%)

HTN, 165 (15%)

6 (0.5%)

5 (2.9%)

9 (0.8%)/T

5 (0.5%)/T

15 (0.4%)/ T

CVD, 27 (2.5%)

9 (5.2%)/S

5 (2.9%)/S

14 (8.1%)/ S

DM, 81 (7.4%)

CKD, 8 (0.7%)

Yang et al, 2020 [11]/China

Critically ill patients, 17 (33%) patients with Huanan sea market exposure

35 (67%)

HTN ( NA)

15 (29%)

9 (17%)/T

6 (11.5%)/T

32 (61.5%)

CVD, 2 (10%)

8 (25%)/S

5 (16%)/S

DM, 2 (10%)

CKD, NA

Zhou et al, 2020 [23]/China

191

119 (62%)

HTN, 58 (30%)

28 (15%)

27 (50%)

10 (5%)/T

3 (2%)/T

54 (28.2%)

CVD, 15 (8%)

10 (19%)/S

3 (6%)/S

DM, 36 (19%)

CKD, 2 (1%)

Huang et al, 2020 [9]/China

27 (66%) patients with Huanan sea market exposure. Among them 9 (69%) needed ICU care

30 (73%)

HTN, 6 (15%)

3 (7%)

3 (23%)

3 (7%)/T

2 (5%)/T

6 (15%)/ T

CVD, 6 (15%)

3 (23%)/I

2 (15%)/I

5 (38%)/ I

DM, 8 (20%)

CKD (NA)

Chen et al, 2020 [28]/China

49 (49%) patients with Huanan sea market exposure

67 (68%)

HTN (NA)

3 (3%)

9 (9%)

3 (3%)

11 (11%)

CVD, 40 (40%)

DM, 12 (12%)

CKD (NA)

Wu et al, 2020 [10]/China

201

128 (63.7%)

HTN, 39 (19.4%)

9 (4.5%)

1 (0.5%)

44 (22%)

CVD, 8 (14%)

DM, 22 (11%)

CKD, 2 (1%)

Cheng et al, 2020 [22]/China

710

374 (52.6%)

HTN (NA)

22 (3.2%)

89 (12.3%)

CVD( NA)

DM (NA)

CKD (NA)

Cheng et al, 2020 [13]/China

701

367 (52.4%)

HTN, 233 (33.4%)

36 (5.1%)

113 (16.1%)

CVD (NA)

DM, 100 (14.3%)

CKD, 14 (2%)

Arentz et al, 2020 [29]/USA

11 (52%)

HTN (NA)

4 (19.1%)

11 (52.4%)

CVD, 9 (42.9%)

DM, 7 (33.3%)

CKD, 10 (47.6%)

ESRD, 2 (9.5%)

Zhang et al, 2020 [24]/China

221

108 (48.9%)

HTN, 54 (24.4%)

10 (4.5%)

8 (14.5%)

5 (2.3%)/T

10 (4.5%)

12 (5.4%)

DM, 22 (10%)

4 (7.3%)/S

10 (18.2%)

CVD, 22 (10%)

CKD, 6 (2.7%)

Diao et al,2020 [19]/China

48 (56%)

HTN, 17 (20%)

23 (27%)

DM, 7 (8%)

CVD, 16 (18%)

CKD, 5 (5.8%)

Cao et al, 2020 [30]/China

199

120 (60.3%)

DM, 23 (11.6%)

9 (4.5%)

4 (2%)

44 (22%)

HTN (NA)

CVD (NA)

CKD (NA)

Wan et al, 2020 [31]/China

135

72 (53.3%)

HTN, 13 (9.6%)

5 (3.7%)

1 (2.5%)

5 (3.7%)/T

1 (0.7%)

CVD, 7 (5.2%)

4 (10%)/S

DM, 12 (8.9%)

CKD (NA)

Cao et al, 2020 [32]/China

198

101 (51%)

HTN, 42 (21.1%)

10 (5.3%)

3 (15.8%)

CVD, 12 (6 %)

DM, 15 (7.6%)

CKD (NA)