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A validation study of UCSD-Mayo risk score in predicting hospital-acquired acute kidney injury in COVID-19 patients
Authors:Zhengying Fang  Chenni Gao  Yikai Cai  Lin Lu  Haijin Yu  Hafiz Muhammad Jafar Hussain  Zijin Chen  Chuanlei Li  Wenjie Wei  Yuhan Huang  Xiang Li  Shuwen Yu  Yinhong Ji  Qinjie Weng  Yan Ouyang  Xiaofan Hu  Jun Tong  Jian Liu  Mingyu Liu  Xiaoman Xu  Yixin Zha  Zhiyin Ye  Tingting Jiang  Jieshuang Jia  Jialin Liu  Yufang Bi  Nan Chen  Weiguo Hu  Huiming Wang  Jun Liu  Jingyuan Xie
Abstract:IntroductionAcute kidney injury (AKI) in coronavirus disease 2019 (COVID-19) patients is associated with poor prognosis. Early prediction and intervention of AKI are vital for improving clinical outcome of COVID-19 patients. As lack of tools for early AKI detection in COVID-19 patients, this study aimed to validate the USCD-Mayo risk score in predicting hospital-acquired AKI in an extended multi-center COVID-19 cohort.MethodsFive hundred seventy-two COVID-19 patients from Wuhan Tongji Hospital Guanggu Branch, Wuhan Leishenshan Hospital, and Wuhan No. Ninth Hospital was enrolled for this study. Patients who developed AKI or reached an outcome of recovery or death during the study period were included. Predictors were evaluated according to data extracted from medical records.ResultsOf all patients, a total of 44 (8%) developed AKI. The UCSD-Mayo risk score achieved excellent discrimination in predicting AKI with the C-statistic of 0.88 (95%CI: 0.84–0.91). Next, we determined the UCSD-Mayo risk score had good overall performance (Nagelkerke R2 = 0.32) and calibration in our cohort. Further analysis showed that the UCSD-Mayo risk score performed well in subgroups defined by gender, age, and several chronic comorbidities. However, the discrimination of the UCSD-Mayo risk score in ICU patients and patients with mechanical ventilation was not good which might be resulted from different risk factors of these patients.ConclusionsWe validated the performance of UCSD-Mayo risk score in predicting hospital-acquired AKI in COVID-19 patients was excellent except for patients from ICU or patients with mechanical ventilation.
Keywords:COVID-19   proximal tubule   acute kidney injury   risk factors
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