The coronavirus (COVID-19) pandemic has created a significant strain on health care resources across the world for managing critically ill patients. Emerging reports from China, South Korea and Italy have reported varying incidence of acute kidney (AKI) ranging from 5-15% with a mortality of 60-80% however there is no systematic assessment of the risk factors, recognition, course and outcomes in patients with and without kidney disease whose course is complicated by AKI1-4. Patients with underlying CKD, immunosuppressed patients with renal transplants and ESKD patients are at high risk for COVID-19 infection and there is limited information on the effect of COVID-19 on the course and outcomes of these patients. The requirement for renal support including IHD, CRRT and sorbent based therapies has been variable and has contributed to the intense pressure on the nephrology and critical care providers for delivering these therapies. As the COVID-19 pandemic expands in the USA and abroad, there is an intense need to understand the epidemiology of the disease and the resources needed for renal support to inform clinical management and public health interventions. In this study, the investigators aim to investigate health care facilities across the world (hospital wards, ICU, outpatient clinics, nursing homes, healthcare centers) to draw a global picture of incidence, risk factors, resources available for treatment and prognosis of acute and chronic kidney disease in patient with COVID 19 confirmed infection. The aim is to identify trends in patients with acute and chronic kidney disease, determine its incidence, treatment and outcomes in different settings across the world. This information will be used to develop and implement educational tools and resources to prevent deaths from AKI and progression of CKD in this and following pandemics.
Acute and Chronic kidney diseases are important causes of mortality and morbidity worldwide.
The associated socioeconomic burden of kidney disease and AKI, as in some cases recovery is
incomplete and chronic kidney disease (CKD) can arise, is a growing problem around the world.
During the COVID 19 pandemic the incidence of AKI has been reported to be as low as 0.5% to
as high as 23%. AKI was reported to develop at a median of 15 days in one study, and another
study reported that most AKI developed within 7 days of admission. The data on acute kidney
injury (AKI) in patients with COVID-19 is mostly from patients who are hospitalized, and in
some studies limited to critically ill patients in the ICU. In ICU patients the requirement
for renal support and mortality is reported to be high, however is a lack of epidemiological
studies specifically designed to determine the impact of COVID 19 on kidney outcomes.
The mortality rate of patients with kidney dysfunction varies widely and is inversely related
to country income and percentage of gross domestic product spent on total health expenditure.
Several initiatives will be very insightful and identified important gaps in knowledge, more
effort is required to understand this problem affecting all regions of the globe. In order to
eventually implement resources and tools to help prevent, diagnose and treat patients with
COVID 19 infection and kidney dysfunction, the investigators need to understand its
incidence, risk factors, available resources and barriers to diagnosis and treatment.
This project will collect data on kidney function progression in patients infected with COVID
19 across the world. The study will open to individual physicians across the world who agreed
to participate by providing de-identified clinical and lab data of patients with confirmed
COVID 19 infection with acute and chronic kidney dysfunction.
Primary Objectives:
1. Establish incidence and outcomes of acute kidney injury (AKI) in different settings
worldwide during the COVID 19 pandemic.
Secondary Objectives:
1. Compare risk factors, etiologies, diagnosis, management and outcomes of acute and
chronic kidney dysfunction in COVID 19 patients in different countries
2. Determine resources available for recognition, non-dialytic and dialytic management and
follow up of patients with acute and chronic kidney dysfunction and COVID 19 infection
in different settings and countries.
3. Determine long term outcomes, 6 months and 1 year, of patients with acute and chronic
kidney dysfunction and COVID 19 infection in different settings.
4. Evaluate barriers preventing access to the standard treatments of acute and chronic
kidney dysfunction and COVID 19 infection across different countries.
5. Determine the impact of COVID 19 infection on the progression of acute and chronic
kidney disease in patient with native and transplanted kidney.
6. Evaluate the treatment strategies of patient with ESKD on hospitalized patients with
COVID 19.
Inclusion Criteria:
- Patients with confirmed infection with COVID 19
- Patients with Acute Kidney injury (AKI) or Chronic kidney disease (CKD) or need for
dialysis
- Patients receiving Chronic dialysis (hemo or peritoneal dialysis)
- Renal transplant recipients
Exclusion Criteria:
- • Patients < 18 yrs age
University of Alabama, Birmingham
Birmingham, Alabama, United States
University of California, San Diego
San Diego, California, United States
University of Colorado
Aurora, Colorado, United States
St. Peter's Hospital
Albany, New York, United States
Jacobi Medical Center
New York, New York, United States
Hospital Obrero #2
Cochabamba, Bolivia
Hopital Sacre Coeur & Universite de Montreal
Montreal, Quebec, Canada
Universidad de Los Andes
Santiago, Chile
Postgraduate Institute of Research, Chandigarh
Chandigarh, India
Royal Free Hospital
London, United Kingdom
Guy's & St Thomas's Hospital
London, United Kingdom
University of Nottingham
Nottingham, United Kingdom
Ravindra L Mehta, Principal Investigator
University of California, San Diego