COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup

• Type of Material: Article
• Authors: Mitra K. Nadim, University of Southern California; Lui G. Forni, University of Surrey; Ravindra L. Mehta, University of California San Diego; Michael Connor, Emory University; Kathleen D. Liu, University of California San Francisco; Marlies Ostermann, Guy’s & St Thomas’ NHS Foundation Hospital; Thomas Rimmele, Hospices Civils de Lyon; Alexander Zarbock, University Hospital Münster; Samira Bell, University of Dundee; Azra Bihorac, University of Florida
• Language: English
• Date: 2020-10-15
• Publisher: NATURE PORTFOLIO
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2020
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41581-020-00356-5
• Title of Journal or Parent Work: NATURE REVIEWS NEPHROLOGY
• Volume: 16
• Issue: 12
• Start Page: 747
• End Page: 764
• Grant/Funding Information: This conference was supported by Unrestricted Educational Grants from Baxter, CytoSorbents, BioMerieux, Jafron, NxStage and Medtronic.
• Keywords: Life Sciences & Biomedicine; COVID-19; Urology & Nephrology; SEPTIC SHOCK; Science & Technology; POLYMYXIN-B HEMOPERFUSION; PERITONEAL-DIALYSIS; NEW-YORK-CITY; CORONAVIRUS; CRITICALLY-ILL PATIENTS; RENAL-REPLACEMENT THERAPY; HOSPITALIZED-PATIENTS; BALANCED CRYSTALLOIDS
• Research Categories: Biology, Virology; Health Sciences, Medicine and Surgery

Abstract

Kidney involvement in patients with coronavirus disease 2019 (COVID-19) is common, and can range from the presence of proteinuria and haematuria to acute kidney injury (AKI) requiring renal replacement therapy (RRT; also known as kidney replacement therapy). COVID-19-associated AKI (COVID-19 AKI) is associated with high mortality and serves as an independent risk factor for all-cause in-hospital death in patients with COVID-19. The pathophysiology and mechanisms of AKI in patients with COVID-19 have not been fully elucidated and seem to be multifactorial, in keeping with the pathophysiology of AKI in other patients who are critically ill. Little is known about the prevention and management of COVID-19 AKI. The emergence of regional ‘surges’ in COVID-19 cases can limit hospital resources, including dialysis availability and supplies; thus, careful daily assessment of available resources is needed. In this Consensus Statement, the Acute Disease Quality Initiative provides recommendations for the diagnosis, prevention and management of COVID-19 AKI based on current literature. We also make recommendations for areas of future research, which are aimed at improving understanding of the underlying processes and improving outcomes for patients with COVID-19 AKI.