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Renal team publish first UK research on Acute Kidney Injury due to Covid-19

renal team socially distanced

A Renal Consultant and his colleagues have published the first piece of research in the UK and only the second in Europe about how Covid-19 patients who also develop Acute Kidney Injury (AKI) are adversely affected by the virus.

Dr Nitin Kolhe, Consultant Nephrologist at UHDB, has conducted research alongside his colleagues into patients who have contracted Covid-19. They have specifically looked at the effects on the kidneys in the form of AKI which has shown to drastically increase mortality rates.

The paper, titled ‘Acute Kidney Injury associated with Covid-19: A retrospective cohort study’ has been published in PLOS Medicine journal and is one of only a handful of similar studies to date.

AKI affects 10 – 20 per cent of hospital admissions and can occur in patients with severe sepsis due to any cause, as well as being caused by severe dehydration, overuse of painkillers and heartburn medication or as a result of other organs failing or after complications from other surgeries. It causes sudden damage to the kidneys which prevents them from working properly and the effects can be as serious as causing complete kidney failure.

Dr Kolhe said: “When the virus reached Italy, we saw many patients in intensive care with multiple organ failure requiring kidney replacement therapies. When the virus hit the UK, it was clear that we needed to study the effect Covid-19 has on the kidneys. We found that not only were the kidneys disproportionately affected, but the AKI it caused appeared to be much more severe.

“This had resulted in a huge increase in the proportion of patients needing kidney replacement therapies in England.

“As time went by, we realised when Covid-19 affects the kidneys, the prognosis for the patient is significantly worse with much higher mortality rates than if the patient was suffering with Covid-19 alone.

“For this reason, it is important to find out exactly how Covid-19 affects the kidneys and if it’s different to AKI.”

Dr Kolhe’s initial findings suggest that mortality rates of those with AKI and Covid-19 are 60.5%, which is much higher than in Covid-19 negative patients, where mortality for AKI is 27.6%.

It remains unclear as to exactly why this is, but research is continuing around the world to try to further our understanding of the wider impacts Covid-19 is having on patients.

Dr Kolhe and his colleagues have previously worked to introduce the AKI Care Bundle at UHDB, which is an electronic system aimed at identifying patients with early stage AKI to prevent their condition from worsening and causing more severe damage to the kidneys. This same Care Bundle is used to help treat for patients with AKI due to Covid-19.

Further research hopes to find out if patients who suffer with AKI as a result of Covid-19 go on to develop chronic kidney disease, something which Dr Kolhe suspects is highly likely:

“Normally, in patients solely suffering with AKI, the number of patients that develop chronic kidney disease is 24%, but I suspect this will be higher in those who have had Covid-19. I’ll also be looking at how much follow-up care these patients require and we are supported by the National Kidney Federation.

“It gives us more information as to how to deal with these patients and how to plan their follow-up care to prevent us from seeing a cohort of patients who survived Covid-19 with chronic kidney conditions.”

Dr Magnus Harrison, Executive Medical Director, said: “This is a remarkable achievement by Dr Kolhe and the Renal team, so well done to everyone involved in this study. It puts the research we’re undertaking on the map on a global scale.”

Download Dr Kolhe's article on PLOS Medicine (opens in new window) [pdf] >