COVID-19患者急性肾损伤

E. Sakaeva, A. М. Shutov, E. V. Efremova, Irina Olegovna Popondopolo
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引用次数: 5

摘要

急性肾损伤(AKI)往往使COVID-19的进展复杂化,并增加住院死亡率。本研究的目的是分析COVID-19患者AKI的发生频率、发生时间以及将血尿素氮/血肌酐(BUN/Cr)比值作为AKI进展的生物标志物的可能性。材料和方法。作者检查了329例因COVID-19住院的患者,其中女性157例(47.7%),男性172例(52.3%),平均年龄58.0±14.3岁。随访期为12个月。经PCR检测确诊为新冠肺炎。研究所有患者AKI发生频率、严重程度和时间。此外,作者还计算了血尿素氮/血肌酐的比值(BUN/Cr, mg/dl:mg/dl)。结果。70例(21.3%)患者被诊断为AKI,其中12例(17.1%)患者住院后肌酐水平升高(院内AKI), 58例(82.9%)患者肌酐水平较高(院前AKI)。AKI 1期55例(78.6%),2期11例(15.7%),3期4例(5.7%)。COVID-19合并AKI患者住院死亡率为10%,COVID-19合并AKI患者的相对死亡风险为5.3% (95%,CI 1.7 ~ 16.1;p = 0.01)。住院AKI患者中,16例(27.6%)患者住院时AUB/Cr>20。院内AKI患者中,只有1人(8%)检出AUB/Cr>20。结论。因COVID-19住院的患者中有四分之一会发展为AKI,主要是第一阶段。急性肾损伤增加住院死亡率。在大多数患者中,AKI在住院前发生。在27.6%的院前AKI患者中,住院时AUB/Cr>20,这表明AKI的预防性以及脱水(低血容量)作为COVID-19患者AKI进展的危险因素的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ACUTE KIDNEY INJURY IN COVID-19 PATIENTS
Acute kidney injury (AKI) often complicates the progression of COVID-19 and increases in-hospital mortality. The aim of the study is to analyze AKI frequency, the time of its development and the possibility of using the ratio blood urea nitrogen/blood creatinine (BUN/Cr) as a biomarker for AKI progression in COVID-19 patients. Materials and methods. The authors examined 329 patients hospitalized with COVID-19 (157 women (47.7 %) and 172 men (52.3 %), mean age 58.0±14.3 years). The follow-up period was 12 months. COVID-19 was confirmed by a PCR test. AKI frequency, severity and time of development were studied in all patients. Moreover, the authors calculated the ratio blood urea nitrogen/blood creatinine (BUN/Cr, mg/dl:mg/dl). Results. AKI was diagnosed in 70 patients (21.3 %), including 12 patients (17.1 %) with an increase in creatinine level after hospitalization (in-hospital AKI) and 58 patients (82.9 %) with a high creatinine level (pre-hospital AKI). AKI stage 1 was observed in 55 patients (78.6 %), stage 2 – in 11 patients (15.7 %), stage 3 – in 4 patients (5.7 %). In-hospital mortality in COVID-19 patients with AKI was 10 %, the relative mortality risk in COVID-19 patients with AKI was 5.3 (95 %, CI 1.7–16.1; p=0.01). In patients hospitalized with AKI, AUB/Cr>20 was observed on hospitalization in 16 patients (27.6 %). In patients with in-hospital AKI, AUB/Cr>20 was detected only in 1 person (8 %). Conclusion. One in four patients hospitalized with COVID-19 develop AKI, predominantly stage 1. AKI increases in-hospital mortality. In most patients, AKI develops before hospitalization. In 27.6 % of patients with pre-hospital AKI, AUB/Cr>20 on hospitalization, which indicates the prerenal nature of AKI and the importance of dehydration (hypovolemia) as a risk factor for AKI progression in COVID-19 patients.
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