Look-up in Google Scholar
Title: Factores asociados al desarrollo de injuria renal aguda en pacientes hospitalizados por COVID-19 en dos hospitales públicos en Lima, Perú
Other Titles: Factors associated with the development of acute kidney injury in patients hospitalized for COVID-19 in two public hospitals in Lima, Peru
Advisor(s): Loza Munarriz, Cesar Antonio; Venegas Justiniano, Joanna Yanissa
OCDE field: http://purl.org/pe-repo/ocde/ford#3.02.08; http://purl.org/pe-repo/ocde/ford#3.03.08
Issue Date: 2024
Institution: Universidad Peruana Cayetano Heredia
Abstract: Introducción: La infección por SARS-CoV-2 fue declarada pandemia por la OMS en el año 2020. Se han descrito factores asociados al desarrollo de Injuria Renal Aguda (IRA) en pacientes con COVID-19 como la edad, sexo masculino, obesidad y ventilación mecánica. Objetivos: Evaluar si las siguientes variables constituyen factores asociados a la ocurrencia de IRA: edad mayor a 60 años, sexo masculino, Hipertensión Arterial, Diabetes Mellitus, obesidad, nefrotóxicos, linfopenia, marcadores inflamatorios (Ferritina, LDH, PCR, Dímero D), Insuficiencia Respiratoria Aguda hipoxémica y VMI. Materiales y métodos: La presente es un diseño de casos y controles con casos prevalentes. Los datos fueron obtenidos de historias clínicas de pacientes adultos hospitalizados con COVID-19 del Hospital Cayetano Heredia y del Hospital Nacional Arzobispo Loayza durante enero a marzo del año 2021. Los casos son pacientes con COVID-19, con diagnóstico de IRA y los controles aquellos COVID-19 sin IRA. Resultados: Se evaluaron 211 casos y 211 controles; los casos estuvieron hospitalizados mayormente en emergencia (20.9% vs 10.0%) y en la unidad de cuidados intensivos (29.4% vs 24.6%) (p = 0.001) y la tasa de mortalidad fue mayor en los pacientes con IRA (49.3% vs 33.25, p= 0.002). En el análisis bivariado la presencia de HTA, de Obesidad, Diabetes, mayores niveles de PCR, mayores niveles de ferritina, presencia de linfopenia, menores niveles de la PaO2 y exposición a nefrotóxicos se asociaron a la presencia de IRA. En el análisis multivariado solo la condición de ser HTA [ORa: 3.78 (2.35 – 6.20); p = 0.001]; ser diabético [ORa: 2.06 (1.17 – 3.71); p = 0.014] y el uso de fármacos nefrotóxicos [ORa: 3.12 (1.92 – 5.14); p = 0.001] se asociaron en forma independiente a la ocurrencia de IRA: solo la presencia de linfopenia [ORa: 0.51 (0.32 – 0.81); p = 0.004], constituyó en un factor protector para la ocurrencia de IRA en los pacientes infectados con Covid-19. Conclusión: Tener HTA, DM y el uso de fármacos nefrotóxicos se asociaron a la ocurrencia de IRA en pacientes infectados con Covid-19.

Introduction: SARS-CoV-2 infection was declared a pandemic by the WHO in 2020. Factors associated with the development of Acute Kidney Injury (AKI) in COVID-19 patients have been described, such as age, male sex, obesity and mechanical ventilation. Objectives: To evaluate if the following variables constitute factors associated with the appearance of AKI: age over 60 years, male sex, hypertension (HTA), Diabetes Mellitus (DM), obesity, nephrotoxic drugs, lymphopenia, inflammatory markers (Ferritin, LDH, CRP, D-dimer), hypoxemic respiratory failure and VMI. Materials and methods: This is a case-control design, with prevalent cases. The data were obtained from the medical records of adult patients hospitalized with COVID-19 at the Cayetano Heredia Hospital and the Arzobispo Loayza National Hospital during January to March 2021. The cases are patients with COVID-19, with a diagnosis of AKI, and the controls, those with COVID-19 without AKI. Results: 211 cases and 211 controls were evaluated. The cases were mostly hospitalized in the emergency department (20.9% vs 10.0%) and in the intensive care unit (29.4% vs 24.6%) (p = 0.001) and the mortality rate was higher in patients with AKI (49.3% vs 33.25) . p= 0.002). In the bivariate analysis, the presence of HTA, Obesity, DM, higher levels of CRP, ferritin, presence of lymphopenia, lower levels of PaO2 and exposure to nephrotoxic drugs were associated with the presence of AKI. In the multivariate analysis, only the condition of being HTA was considered [ORa: 3.78 (2.35 – 6.20); p = 0.001]; being diabetic [ORa: 2.06 (1.17 – 3.71); p = 0.014] and the use of nephrotoxic drugs [ORa: 3.12 (1.92 – 5.14); p = 0.001] were independently associated with the occurrence of AKI: only the presence of lymphopenia [ORa: 0.51 (0.32 – 0.81); p = 0.004], constituted a protective factor for the appearance of AKI in patients infected with COVID-19. Conclusion: Having HTA, DM and the use of nephrotoxic drugs were associated with the occurrence of AKI in patients infected with Covid-19.
Discipline: Medicina
Grade or title grantor: Universidad Peruana Cayetano Heredia. Facultad de Medicina Alberto Hurtado
Grade or title: Médico Cirujano
Juror: Hurtado García, Maria Elena; Rosales Mendoza, Karina Janet; Ayala Diaz, Pedro Guillermo
Register date: 20-Jun-2024



This item is licensed under a Creative Commons License Creative Commons