A validation study of UCSD-Mayo risk score in predicting hospital-acquired acute kidney injury in COVID-19 patients

Ren Fail. 2021 Dec;43(1):1115-1123. doi: 10.1080/0886022X.2021.1948429.

Abstract

Introduction: Acute 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.

Methods: Five 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.

Results: Of 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.

Conclusions: We 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; acute kidney injury; proximal tubule; risk factors.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / mortality
  • Adult
  • Aged
  • COVID-19 / complications*
  • COVID-19 / mortality
  • China / epidemiology
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index*

Grants and funding

This work was supported by grants from the National Natural Science Foundation of China (No. 81870460, 81570598, 81370015), Science and Technology Innovation Action Plan of Shanghai Science and Technology Committee (No. 17441902200), Shanghai Municipal Education Commission, Gaofeng Clinical Medicine Grant (No. 20152207), Shanghai Jiao Tong University School of Medicine, Multi-Center Clinical Research Project (No. DLY201510), Shanghai Health and Family Planning Committee Hundred Talents Program (No. 2018BR37), Shanghai Jiao Tong University “Jiaotong Star” Plan Medical Engineering Cross Research Key Project (No. YG2019ZDA18), Shanghai Municipal Key Clinical Specialty (No. shslczdzk02502) and Shanghai Shenkang Hospital Development Center Three-Year Action Plan to Promote Clinical Skills and Clinical Innovation in Municipal Hospitals Program (No. SHDC2020CR6017).