The role of kidney dysfunction in COVID-19 and the influence of age

Edoardo La Porta, Paola Baiardi, Lorenzo Fassina, Alessandro Faragli, Simone Perna, Federico Tovagliari, Ilaria Tallone, Giuseppina Talamo, Giovanni Secondo, Giovanni Mazzarello, Vittoria Esposito, Matteo Pasini, Francesca Lupo, Giacomo Deferrari, Matteo Bassetti, Ciro Esposito

Research output: Contribution to journalArticlepeer-review


COVID-19 is strongly influenced by age and comorbidities. Acute kidney injury (AKI) is a frequent finding in COVID-19 patients and seems to be associated to mortality and severity. On the other hand, the role of kidney dysfunction in COVID-19 is still debated. We performed a retrospective study in a cohort of 174 hospitalized COVID-19 patients in Italy from March 3rd to May 21st 2020, to investigate the role of kidney dysfunction on COVID-19 severity and mortality. Moreover, we examined in depth the relationship between kidney function, age, and progression of COVID-19, also using different equations to estimate the glomerular filtration rate (GFR). We performed logistic regressions, while a predictive analysis was made through a machine learning approach. AKI and death occurred respectively in 10.2% and 19.5%, in our population. The major risk factors for mortality in our cohort were age [adjusted HR, 6.2; 95% confidence interval (CI) 1.8-21.4] and AKI [3.36 (1.44-7.87)], while, in these relationships, GFR at baseline mitigated the role of age. The occurrence of AKI was influenced by baseline kidney function, D-dimer, procalcitonin and hypertension. Our predictive analysis for AKI and mortality reached an accuracy of ≥ 94% and ≥ 91%, respectively. Our study scales down the role of kidney function impairment on hospital admission , especially in elderly patients. BIS-1 formula demonstrated a worse performance to predict the outcomes in COVID-19 patients when compared with MDRD and CKD-EPI.

Original languageEnglish
Pages (from-to)8650
JournalSci. Rep.
Issue number1
Publication statusPublished - May 23 2022


  • Acute Kidney Injury/epidemiology
  • Aged
  • COVID-19/complications
  • Glomerular Filtration Rate
  • Humans
  • Kidney
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2


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