Most COVID-19 Patients with AKI Regain Kidney Function

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Recovery of kidney function is common for COVID-19 patients with acute kidney injury requiring kidney replacement therapy (AKI-KRT), according to a report in Kidney International.

Researchers at a large German tertiary care center report their experience with 74 hospitalized patients who developed AKI-KRT as a complication of COVID-19 between March and June 2020. The patients’ median age was 65 years and three-fourths were men. All patients were in the ICU when AKI-KRT developed. Nearly all were on mechanical ventilation, and 39.2% were receiving extracorporeal membrane oxygenation.

Outcomes were assessed in October 2020—a median of 151 days after the start of KRT. In 37 patients who survived to discharge, median duration of KRT was 27 days. At follow-up, 62.2% of patients had complete recovery of kidney function while 91.9% had partial recovery. Just 3 patients (8.1% of survivors) were still KRT dependent.

From the start of the COVID-19 pandemic, AKI-KRT has been recognized as a common complication. This series of critically ill COVID-19 patients with AKI-KRT suggests that most survivors will have recovery of kidney function at follow-up in the months after discharge. Recovery can occur even after prolonged periods of KRT. “This information may be of value for patients with COVID-19 and their clinicians when it comes to deciding about the initiation or discontinuation of KRT,” the researchers write [Stockmann H, et al. High rates of long-term renal recovery in survivors of COVID-19-associated acute kidney injury requiring kidney replacement therapy. Kidney Int 2021; 99:1021−1022. doi: 10.1016/j.kint.2021.01.005.