Chronic Anticoagulation Fails to Lower AKI Risk in COVID-19 Patients

Pavankumar Kamat


July 09, 2021


  • Chronic anticoagulation does not reduce the risk of acute kidney injury (AKI) and its severity, including the need for renal replacement therapy (RRT) in hospitalised patients with COVID-19.

Why this matters

  • Findings suggest that renal microvascular thrombosis is unlikely to play a vital role in COVID-19-related AKI, which is more likely to be multifactorial, warranting early detection and management.

Study design

  • A retrospective study reviewed electronic records of 1032 patients with COVID-19 (age, >18 years) who were admitted to Manchester University Foundation Trust Hospitals between 10 March and 30 April 2020.

  • AKI was classified according to the Kidney Disease Improving Global Outcomes criteria.

  • Funding: None.

Key results

  • Of the 1032 patients, 164 (15.9%) received anticoagulant therapy prior to hospital admission.

  • No significant difference was seen between patients who received anticoagulants and those who did not in:

    • rates of AKI (23.8% vs 19.7%; P=.278);

    • severity of AKI stage III (48.7% vs 42.7%; P=.783); and

    • need for RRT (1.2% vs 3.5%; P=.204).

  • In multivariate analysis, anticoagulation was not associated with AKI (OR, 1.02; 95% CI, 0.60-1.68; P=.952).

  • Risk factors for AKI were (OR; 95% CI):

    • pre-existing renal disease (2.31; 1.42-3.72; P=.001);

    • hypertension (1.61; 1.07-2.46; P=.024); and

    • male gender (1.65; 1.11-2.49; P=.015).


  • Retrospective.


Parker K, Hamilton P, Hanumapura P, Castelino L, Murphy M, Challiner R, Thachil J, Ebah L. Chronic anticoagulation is not associated with a reduced risk of acute kidney injury in hospitalised Covid-19 patients. BMC Nephrol. 2021;22(1):224. doi: 10.1186/s12882-021-02436-5. PMID: 34134645.  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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