Acute kidney injury in patients hospitalized with COVID-19 from the ISARIC WHO CCP-UK Study: a prospective, multicentre cohort study.
Acute kidney injury in patients hospitalized with COVID-19 from the ISARIC WHO CCP-UK Study: a prospective, multicentre cohort study.
复制标题
DOI：
10.1093/ndt/gfab303
复制
发表时间：
2022-01-25
期刊：
影响因子：
--
通讯作者：
Mark PB
中科院分区：
文献类型：
--
作者：
Sullivan MK;Lees JS;Drake TM;Docherty AB;Oates G;Hardwick HE;Russell CD;Merson L;Dunning J;Nguyen-Van-Tam JS;Openshaw P;Harrison EM;Baillie JK;ISARIC4C Investigators;Semple MG;Ho A;Mark PB
急性肾损伤（阿基）在2019冠状病毒病（COVID-19）中很常见。这项研究调查了因COVID-19住院的成年人，并假设阿基的风险因素包括合并症和非白人种族。一项前瞻性多中心队列研究是针对2020年1月17日至2020年12月5日期间在英国254家医院接受COVID-19治疗的患者进行的。在85687例患者中，2198例（2.6%）接受了急性肾脏替代治疗（KRT）。在41294例有生化数据的患者中，13000例（31.5%）有生化阿基：8562例1期（65.9%）、2609例2期（20.1%）和1829例3期（14.1%）。KRT的主要危险因素为慢性肾脏病（CKD）[校正比值比（aOR）3.41：95%置信区间3.06-3.81]、男性（aOR 2.43：2.18-2.71）和黑人（aOR 2.17：1.79-2.63）。生化阿基的主要危险因素为入院呼吸频率>30次/min（aOR 1.68：1.56-1.81）、CKD（aOR 1.66：1.57-1.76）和黑人（aOR 1.44：1.28-1.61）。随着阿基严重程度的增加，28天死亡率的风险逐渐升高：1期aOR 1.58（1.49-1.67），2期aOR 2.41（2.20-2.64），3期aOR 3.50（3.14-3.91）和KRT aOR 3.06（2.75-3.39）。阿基发病率在2020年4月达到峰值，随后的发病率下降不能用地塞米松或瑞德西韦的使用来解释。阿基在因COVID-19住院的成年人中很常见，与死亡风险增加有关。虽然阿基的发病率从大流行的最初几个月开始下降，但高危患者应密切监测肾功能和液体状态。
Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19). This study investigated adults hospitalized with COVID-19 and hypothesized that risk factors for AKI would include comorbidities and non-White race. A prospective multicentre cohort study was performed using patients admitted to 254 UK hospitals with COVID-19 between 17 January 2020 and 5 December 2020. Of 85 687 patients, 2198 (2.6%) received acute kidney replacement therapy (KRT). Of 41 294 patients with biochemistry data, 13 000 (31.5%) had biochemical AKI: 8562 stage 1 (65.9%), 2609 stage 2 (20.1%) and 1829 stage 3 (14.1%). The main risk factors for KRT were chronic kidney disease (CKD) [adjusted odds ratio (aOR) 3.41: 95% confidence interval 3.06–3.81], male sex (aOR 2.43: 2.18–2.71) and Black race (aOR 2.17: 1.79–2.63). The main risk factors for biochemical AKI were admission respiratory rate >30 breaths per minute (aOR 1.68: 1.56–1.81), CKD (aOR 1.66: 1.57–1.76) and Black race (aOR 1.44: 1.28–1.61). There was a gradated rise in the risk of 28-day mortality by increasing severity of AKI: stage 1 aOR 1.58 (1.49–1.67), stage 2 aOR 2.41 (2.20–2.64), stage 3 aOR 3.50 (3.14–3.91) and KRT aOR 3.06 (2.75–3.39). AKI rates peaked in April 2020 and the subsequent fall in rates could not be explained by the use of dexamethasone or remdesivir. AKI is common in adults hospitalized with COVID-19 and it is associated with a heightened risk of mortality. Although the rates of AKI have fallen from the early months of the pandemic, high-risk patients should have their kidney function and fluid status monitored closely.
登录
查看更多内容
纽约市Covid-19危重疾病患者急性肾脏损伤的发生率降低。
影响因子：
6
作者：
Charytan DM;Parnia S;Khatri M;Petrilli CM;Jones S;Benstein J;Horwitz LI
通讯作者：
Horwitz LI
影响因子：
19.6
作者：
Chu KH;Tsang WK;Tang CS;Lam MF;Lai FM;To KF;Fung KS;Tang HL;Yan WW;Chan HW;Lai TS;Tong KL;Lai KN
通讯作者：
Lai KN
影响因子：
13.6
作者：
Farkash, Evan A.;Wilson, Allecia M.;Jentzen, Jeffrey M.
通讯作者：
Jentzen, Jeffrey M.
影响因子：
38.9
作者：
Joannidis, Michael;Forni, Lui G.;Kellum, John A.
通讯作者：
Kellum, John A.
影响因子：
2
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.