Background. Acute kidney injury (AKI) is associated with poor outcomes in patients infected with SARS-CoV-2. Sepsis, direct injury to kidney cells by the virus, and severe systemic inflammation are mechanisms implicated in its development. We investigated the association between inflammatory markers (C-reactive protein, procalcitonin, D-dimer, lactate dehydrogenase, and ferritin) in patients infected with SARS-CoV-2 and the development of AKI. Methods: A prospective cohort study performed at the Civil Hospital (Dr. Juan I. Menchaca) Guadalajara, Mexico, included patients aged >18 years with a diagnosis of SARS-CoV-2 pneumonia confirmed by RT-PCR and who did or did not present with AKI (KDIGO) while hospitalized. Biomarkers of inflammation were recorded, and kidney function was estimated using the CKD-EPI formula. Results: 291 patients were included (68% men; mean age, 57 years). The incidence of AKI was 40.5% (118 patients); 21% developed stage 1 AKI, 6% developed stage 2 AKI, and 14% developed stage 3 AKI. The development of AKI was associated with phosphate higher (p = 0.002) (RR 1.39, CI 95% 1.13 - 1.72), high procalcitonin levels at hospital admission (p = 0.005) (RR 2.09, CI 95% 1.26-3.50), and high APACHE scores (p = 0.011) (RR 2.0, CI 95% 1.17-3.40). The survival analysis free of AKI according to procalcitonin levels and APACHE scores demonstrated a lower survival in patients with procalcitonin >0.5 ng/ml (p= 0.001) and APACHE >15 points (p = 0.004). Conclusions: phosphate, high procalcitonin levels, and APACHE scores >15 were predictors of AKI development in patients hospitalized with COVID-19.

The authors have declared no competing interest.

This study did not receive any funding.

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Ethics committee/IRB of Hospital Civil de Guadalajara, and Dr. Juan I Menchaca gave ethical approval for this work. Registration number: 17CI14 039 116 COFEPRIS

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Most clinical data are restricted to protecting information from misuse. The data may be shared by the OPD, Hospital Civil de Guadalajara, and Dr. Juan I Menchaca (HCG-JIM) after approval from the Ethics Committee of the Institution. The data supporting the findings of this study are available from the corresponding author upon reasonable request.