When researchers measured the fall in creatinine levels, the rate of Acute Kidney Injury diagnosis in COVID-19 patients doubled.
Australian researchers believe millions of COVID-19 patients could be going undiagnosed for Acute Kidney Injury (AKI). This potentially fatal disease occurs when that organ suddenly fails to filter waste from the blood, sometimes leading to debilitating sickness or even death. The condition is usually caused by complications from another serious illness.
University of Queensland (UQ) doctoral candidate and kidney specialist Marina Wainstein said existing data indicated that about 20 percent of COVID-19 patients admitted to hospital developed AKI, rising to roughly 40 percent for those in intensive care.
Wainstein, discussing her findings which were published in the online journal PLOS Medicine and released to the public on Friday, said the AKI statistics could be twice as large.
"Doctors look at the amount of urine a patient passes, and the level of a compound called creatinine in the blood, which rises when the kidneys aren't working well. However, if that creatinine rise occurs before a patient presents to the hospital, we can miss the AKI diagnosis and fail to manage the patient appropriately in those early, critical days of hospitalization."
Wainstein said when researchers also measured the fall in creatinine levels, which often follows the initial rise, the rate of AKI diagnosis in COVID-19 patients doubled.
After more than two years of data collection, we will run the last update of our dataset on COVID testing on 23 June.— Our World in Data (@OurWorldInData) May 31, 2022
This decision only applies to testing metrics. We will continue to update the rest of the data as usual.
Find out more: https://t.co/8wY4Y0CzkJ
Even though the AKI is already starting to improve in hospital, our research shows that these patients have worse in-hospital outcomes and are more likely to die compared to patients with no AKI. Wainstein said treatment for AKI can be as simple as checking a patient's hydration levels and stopping medications that can be toxic to the kidneys.
UQ physics senior lecturer Sally Shrapnel said collecting and analyzing data for the project during the pandemic had been challenging.
"Typically data scientists work with complete, well-curated registry data, but in this project, it was collected by hospital staff working under extremely onerous conditions," Shrapnel said, adding that the researchers also included data from "resource-poor" countries, where community-acquired AKI was more common.
These people have limited access to healthcare and are more likely to present late in the disease process. Shrapnel said a more comprehensive definition of AKI - one which can detect cases that develop in the community - needs to be implemented as soon as possible.
"Now we have the data showing a large gap in AKI diagnosis exists, it's time to test this definition in a clinical trial so we can identify all AKI patients early and hopefully prevent these awful outcomes."