COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study

Background: Acute kidney injury (AKI) is a frequent complication associated with severe COVID-19 and has been linked to increased mortality. While vaccination against SARS-CoV-2 has shown effectiveness in reducing severe COVID-19 outcomes, its impact on the development of AKI among hospitalized pati...

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Main Authors: Froylan D. Martínez-Sánchez, Luis A. Bastida-Castro, José L. Torres-Cuevas, Julio A. Vasquez-Vasquez, Alejandra Diaz-Jarquin, Rafael Moreno-Novales, Joana Balderas-Juarez, Mauricio A. Salinas-Ramírez, Jose L. Hernández-Castillo, Erika K. Tenorio-Aguirre
Format: Article
Language:English
Published: SAGE Publishing 2024-11-01
Series:Canadian Journal of Kidney Health and Disease
Online Access:https://doi.org/10.1177/20543581241297369
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author Froylan D. Martínez-Sánchez
Luis A. Bastida-Castro
José L. Torres-Cuevas
Julio A. Vasquez-Vasquez
Alejandra Diaz-Jarquin
Rafael Moreno-Novales
Joana Balderas-Juarez
Mauricio A. Salinas-Ramírez
Jose L. Hernández-Castillo
Erika K. Tenorio-Aguirre
author_facet Froylan D. Martínez-Sánchez
Luis A. Bastida-Castro
José L. Torres-Cuevas
Julio A. Vasquez-Vasquez
Alejandra Diaz-Jarquin
Rafael Moreno-Novales
Joana Balderas-Juarez
Mauricio A. Salinas-Ramírez
Jose L. Hernández-Castillo
Erika K. Tenorio-Aguirre
author_sort Froylan D. Martínez-Sánchez
collection DOAJ
description Background: Acute kidney injury (AKI) is a frequent complication associated with severe COVID-19 and has been linked to increased mortality. While vaccination against SARS-CoV-2 has shown effectiveness in reducing severe COVID-19 outcomes, its impact on the development of AKI among hospitalized patients remains unclear. Objective: To evaluate the effect of SARS-CoV-2 vaccination on the incidence and severity of AKI and 28-day mortality among hospitalized patients with severe COVID-19. Design: Retrospective case-control study. Setting: Conducted at the Internal Medicine Department of Hospital General Dr. Manuel Gea González, Mexico, from April 2020 to December 2021. Patients: 413 patients over 18 with confirmed severe COVID-19 were included. Patients were categorized based on their vaccination status before COVID-19 infection. Measurements: Key outcomes included the incidence of AKI, progression to AKI stage 3, and 28-day mortality. AKI was defined according to the KDIGO criteria. Methods: Data were analyzed using univariate and logistic regression models to assess the association between vaccination status and the studied outcomes. Covariates included age, sex, BMI, type 2 diabetes, hypertension, and inflammatory markers. Results: Among the 413 patients, 70% developed AKI, with a median hospital stay of 10 days (range 6-17). Vaccinated patients had a significantly lower incidence of AKI compared with nonvaccinated patients (48.7% vs 74.9%; P < .001). After adjusting for confounding factors, vaccination was associated with lower odds of AKI (OR: 0.252, 95% CI: 0.140-0.452), AKI stage 3 (OR: 0.448, 95% CI: 0.205-0.981), and 28-day mortality (OR: 0.187, 95% CI: 0.064-0.544). Limitations: As a single-center retrospective study, generalizability is limited. In addition, vaccination data were obtained from medical records, and the completeness of vaccination could not be independently verified. Conclusions: SARS-CoV-2 vaccination was independently associated with a reduced risk of AKI, AKI stage 3, and 28-day mortality in hospitalized patients with severe COVID-19. These findings highlight the potential protective effects of vaccination against severe kidney complications in this population.
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spelling doaj-art-a11df1fe8a9849919b9130a27277cb9b2025-08-20T02:13:56ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812024-11-011110.1177/20543581241297369COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control StudyFroylan D. Martínez-Sánchez0Luis A. Bastida-Castro1José L. Torres-Cuevas2Julio A. Vasquez-Vasquez3Alejandra Diaz-Jarquin4Rafael Moreno-Novales5Joana Balderas-Juarez6Mauricio A. Salinas-Ramírez7Jose L. Hernández-Castillo8Erika K. Tenorio-Aguirre9Facultad de Medicina, Universidad Nacional Autonoma de Mexico, MéxicoDepartment of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, MéxicoDepartment of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, MéxicoFacultad de Medicina, Universidad Nacional Autonoma de Mexico, MéxicoDepartment of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, MéxicoDepartment of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, MéxicoDepartment of Nephrology, Hospital General Dr. Manuel Gea Gonzalez, Ciudad de México, MéxicoDepartment of Nephrology, Hospital General Dr. Manuel Gea Gonzalez, Ciudad de México, MéxicoDepartment of Nephrology, Hospital General Dr. Manuel Gea Gonzalez, Ciudad de México, MéxicoDepartment of Internal Medicine, Hospital General Dr. Manuel Gea González, Ciudad de México, MéxicoBackground: Acute kidney injury (AKI) is a frequent complication associated with severe COVID-19 and has been linked to increased mortality. While vaccination against SARS-CoV-2 has shown effectiveness in reducing severe COVID-19 outcomes, its impact on the development of AKI among hospitalized patients remains unclear. Objective: To evaluate the effect of SARS-CoV-2 vaccination on the incidence and severity of AKI and 28-day mortality among hospitalized patients with severe COVID-19. Design: Retrospective case-control study. Setting: Conducted at the Internal Medicine Department of Hospital General Dr. Manuel Gea González, Mexico, from April 2020 to December 2021. Patients: 413 patients over 18 with confirmed severe COVID-19 were included. Patients were categorized based on their vaccination status before COVID-19 infection. Measurements: Key outcomes included the incidence of AKI, progression to AKI stage 3, and 28-day mortality. AKI was defined according to the KDIGO criteria. Methods: Data were analyzed using univariate and logistic regression models to assess the association between vaccination status and the studied outcomes. Covariates included age, sex, BMI, type 2 diabetes, hypertension, and inflammatory markers. Results: Among the 413 patients, 70% developed AKI, with a median hospital stay of 10 days (range 6-17). Vaccinated patients had a significantly lower incidence of AKI compared with nonvaccinated patients (48.7% vs 74.9%; P < .001). After adjusting for confounding factors, vaccination was associated with lower odds of AKI (OR: 0.252, 95% CI: 0.140-0.452), AKI stage 3 (OR: 0.448, 95% CI: 0.205-0.981), and 28-day mortality (OR: 0.187, 95% CI: 0.064-0.544). Limitations: As a single-center retrospective study, generalizability is limited. In addition, vaccination data were obtained from medical records, and the completeness of vaccination could not be independently verified. Conclusions: SARS-CoV-2 vaccination was independently associated with a reduced risk of AKI, AKI stage 3, and 28-day mortality in hospitalized patients with severe COVID-19. These findings highlight the potential protective effects of vaccination against severe kidney complications in this population.https://doi.org/10.1177/20543581241297369
spellingShingle Froylan D. Martínez-Sánchez
Luis A. Bastida-Castro
José L. Torres-Cuevas
Julio A. Vasquez-Vasquez
Alejandra Diaz-Jarquin
Rafael Moreno-Novales
Joana Balderas-Juarez
Mauricio A. Salinas-Ramírez
Jose L. Hernández-Castillo
Erika K. Tenorio-Aguirre
COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study
Canadian Journal of Kidney Health and Disease
title COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study
title_full COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study
title_fullStr COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study
title_full_unstemmed COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study
title_short COVID-19 and Acute Kidney Injury Outcomes in Hospitalized Patients Following SARS-CoV-2 Vaccination: A Case-Control Study
title_sort covid 19 and acute kidney injury outcomes in hospitalized patients following sars cov 2 vaccination a case control study
url https://doi.org/10.1177/20543581241297369
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