ISARIC Characterization Group2026-01-192026-01-192023-08ISARIC Characterization Group 2023, 'Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19', Kidney International Reports, vol. 8, no. 8, pp. 1514-1530. https://doi.org/10.1016/j.ekir.2023.05.0152468-0249PubMedCentral: PMC10219675https://hdl.handle.net/10641/7411Publisher Copyright: © 2023 International Society of NephrologyIntroduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes.171276451enghttp://creativecommons.org/licenses/by-nc-nd/4.0/COVID-19acute kidney injurycommunity-acquired AKIcountry incomedialysisin-hospital deathNephrologyJournal ArticleYesyesjournal articleopen access10.1016/j.ekir.2023.05.015https://www.scopus.com/pages/publications/85165881923https://www.scopus.com/pages/publications/85165881923#tab=citedBy