Acute kidney injury in patients hospitalized with COVID-19
Acute kidney injury in patients hospitalized with COVID-19
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DOI：
10.1016/j.kint.2020.05.006
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发表时间：
2020-07-01
影响因子：
19.6
通讯作者：
Jhaveri, Kenar D.
中科院分区：
文献类型：
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作者：
Hirsch, Jamie S.;Ng, Jia H.;Jhaveri, Kenar D.
与因Covid-19住院的患者相关的急性肾损伤（阿基）发生率以及相关结局尚不清楚。本研究描述了因Covid-19住院的患者中阿基的表现、风险因素和结局。我们回顾了2020年3月1日至4月5日期间在纽约大都市的13家学术和社区医院住院的所有新冠肺炎患者的健康记录。年龄小于18岁、患有终末期肾病或接受肾移植的患者被排除在外。根据KDIGO标准定义阿基。在5，449名因新冠肺炎入院的患者中，1，993名（36.6%）发生了阿基。阿基的高峰期为1期46.5%，2期22.4%，3期31.1%。其中，14.3%需要肾脏替代治疗（RRT）。阿基主要见于新冠肺炎呼吸衰竭患者，89.7%的机械通气患者发生AKI，而非机械通气患者发生AKI的比例为21.7%。276/285例（96.8%）需要RRT的患者使用了呼吸机。在需要通气并发生阿基的患者中，52.2%在插管后24小时内发生阿基。阿基的风险因素包括老年、糖尿病、心血管疾病、黑人、高血压以及需要通气和血管加压药。在阿基患者中，694例死亡（35%），519例出院（26%），780例仍住院（39%）。阿基经常发生在Covid-19疾病患者中。它发生在早期，与呼吸衰竭暂时相关，并与预后不良相关。
The rate of acute kidney injury (AKI) associated with patients hospitalized with Covid-19, and associated outcomes are not well understood. This study describes the presentation, risk factors and outcomes of AKI in patients hospitalized with Covid-19. We reviewed the health records for all patients hospitalized with Covid-19 between March 1, and April 5, 2020, at 13 academic and community hospitals in metropolitan New York. Patients younger than 18 years of age, with end stage kidney disease or with a kidney transplant were excluded. AKI was de fined according to KDIGO criteria. Of 5,449 patients admitted with Covid-19, AKI developed in 1,993 (36.6%). The peak stages of AKI were stage 1 in 46.5%, stage 2 in 22.4% and stage 3 in 31.1%. Of these, 14.3% required renal replacement therapy (RRT). AKI was primarily seen in Covid-19 patients with respiratory failure, with 89.7% of patients on mechanical ventilation developing AKI compared to 21.7% of non -ventilated patients. 276/285 (96.8%) of patients requiring RRT were on ventilators. Of patients who required ventilation and developed AKI, 52.2% had the onset of AKI within 24 hours of intubation. Risk factors for AKI included older age, diabetes mellitus, cardiovascular disease, black race, hypertension and need for ventilation and vasopressor medications. Among patients with AKI, 694 died (35%), 519 (26%) were discharged and 780 (39%) were still hospitalized. AKI occurs frequently among patients with Covid-19 disease. It occurs early and in temporal association with respiratory failure and is associated with a poor prognosis.