Kidney Week

Abstract: PUB003

Dynamic Evolution of Renal Markers and Mortality Prediction in Hospitalized Hispanic Patients with COVID-19

Session Information

• Publication Only

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Banuelos, Andrew, Florida Kidney Physicians, Coral Springs, Florida, United States

Andrew Banuelos

• Gadh, Rajdeep S., Florida Kidney Physicians, Coral Springs, Florida, United States

Rajdeep S. Gadh, MD

• Kotzker, Wayne R., Florida Kidney Physicians, Coral Springs, Florida, United States

Wayne R. Kotzker, MD

• Delgado-Enciso, Ivan, Universidad de Colima, Colima, Colima, Mexico

Ivan Delgado-Enciso, MD, PhD

• Mendoza Hernandez, Martha Angelica, Mexican Institute of Social Security, Colima, Colima, Mexico

Martha Angelica Mendoza Hernandez, PhD

• Hernandez-Fuentes, Gustavo A., Universidad de Colima, Colima, Colima, Mexico

Gustavo A. Hernandez-Fuentes, PhD

• Esquivel, Jose Guzman, Universidad de Colima, Colima, Colima, Mexico

Jose Guzman Esquivel, MD

• Diaz Martinez, Janet, Florida Kidney Physicians, Coral Springs, Florida, United States

Janet Diaz Martinez, PhD, RD

Group or Team Name

• Hispanic Kidney Researchers.

Background

Kidney dysfunction is common in hospitalized COVID-19 patients and is linked to higher in-hospital mortality. Mortality prediction studies often use renal function markers (BUN, eGFR, AKI) from admission or the first 48 hours. Few studies analyze the evolution of these parameters during hospitalization and their predictive capacity for survival or death.
Objective: To assess the predictive power of BUN and eGFR for mortality at different time points during hospitalization in a cohort of hospitalized Hispanic COVID-19 patients.

Methods

Clinical data were collected at admission and at 2, 4, 6, and 8 days into hospitalization from a cohort of 515 COVID-19 patients at the General Hospital of the Mexican Social Security Institute, Mexico (February 2021 to December 2022). Using time-dependent ROC curve analysis, we calculated the area under the curve (AUC), sensitivity, specificity, and predictive values for BUN and eGFR(ml/min/1.73m2. Patients were stratified based on eGFR was >60 or<60 at admission. Values equal to or above the cutoff point were predictive of mortality for BUN and survival for eGFR. Predictive capacity was classified as 0.50-0.60 (failed), 0.61-0.70 (worthless), 0.71-0.80 (poor), 0.81-0.90 (good), and >0.90 (excellent).

Results

Mean age was 63.3±16.1 years, 61.9% being male. The median length of hospital stay was 7.0 days. BUN and eGFR predictive capacities were more relevant on days 6 [AUC, 0.775 and 0.672] and 8 [AUC, 0.790 and 0.659], respectively. BUN ≥ 25.5 on day 8 predicts death in patients with GFR >60 at admission, while patients with GFR< 60 require a BUN ≥ 57 for this parameter to predict mortality.

Conclusion

BUN had better predictive capacity for mortality than eGFR. A BUN value of 25.5 or higher on day 8 predicts death in patients with adequate renal function at admission, while patients with impaired renal function require a BUN level above 57 to predict mortality.