Risk factors for kidney damage in COVID-19 coronavirus pneumonia

Abstract

The purpose of the study: To identify risk factors for kidney damage in pneumonia caused by COVID-19 coronavirus infection.

Methods. A retrospective analysis of 300 case histories of patients over the age of 18 without fatal outcomes who were admitted to inpatient treatment for coronavirus infection complicated by pneumonia and had no history of urinary tract diseases was carried out. Of the 300 assessed case histories, 103 (34.3%) revealed some changes in urine tests that made up the study group compared with patients who did not have changes in urine tests (comparison group). The patients underwent: clinical blood analysis (UAC), biochemical blood analysis, clinical urine analysis, computed tomography of the lungs (CT), detection of the COVID-19 virus by polymerase chain reaction (PCR) in oropharyngeal and nasopharyngeal smears. Patients in the study group with changes in urine tests after discharge from the hospital were observed for 6–7 months.

Results. It was found that reliable risk factors for covid pneumonia with acute kidney injury (AKI) in our case were: male, young and middle age (18–59 years), moderate CT severity, high incidence of concomitant pathology (most often Hypertension, diabetes mellitus and obesity), increased serum creatinine, D-dimer. Almost 30% of patients with covid pneumonia complicated by AKI needed further dynamic follow-up after discharge from the hospital and did not have recommendations for follow-up by specialists at discharge.

Conclusion. The established risk factors for the course of COVID-19 coronavirus pneumonia in hospitalized patients with AKI allow us to identify a risk group that should be taken into account when managing patients in a hospital and timely prevent the development of glomerular filtration rate – patients with detected proteinuria are recommended: to take curantil 150 mg per day for at least 3 months in order to improve microcirculation of renal blood flow; control of urine tests 1, 2, 3 months after discharge from the hospital and determination of creatinine and GFR levels 3 months after discharge from the hospital; consultation with a nephrologist.