Decreased renal perfusion during acute kidney injury in critical COVID-19 assessed by magnetic resonance imaging: a prospective case control study.
Decreased renal perfusion during acute kidney injury in critical COVID-19 assessed by magnetic resonance imaging: a prospective case control study.
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DOI：
10.1186/s13054-022-04132-8
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发表时间：
2022-09-01
期刊：
影响因子：
15.1
通讯作者：
Liss, Per
中科院分区：
文献类型：
--
作者：
Luther, Tomas;Eckerbom, Per;Cox, Eleanor;Lipcsey, Miklos;Bulow, Sara;Hultstrom, Michael;Torrente, Francisco Martinez;Weis, Jan;Palm, Fredrik;Francis, Susan;Frithiof, Robert;Liss, Per
肾灌注不足被认为是导致重症COVID-19急性肾损伤（阿基）的原因。然而，支持这一点的数据有限。我们的目的是使用多参数磁共振成像研究有和无阿基的重症COVID-19患者的肾脏灌注、氧合和水扩散的差异。 一项前瞻性病例对照研究，对既往无肾脏疾病、因COVID-19导致的呼吸衰竭而接受重症监护治疗的患者进行了检查。肾脏疾病：改善全球结局Credom标准用于组分配。使用Mann-Whitney U检验检验主要比较。对19名患者进行了检查，其中10名患有阿基，9名没有阿基。阿基患者在符合标准后中位数1 [0-2]天内接受检查。两组的年龄和基线血浆肌酐相似。AKI患者的总肾血流量低于无AKI患者（中位数645四分位数范围[423-753] vs. 859 [746-920] ml/min，p = 0.037）。皮质（76 [51-112] vs. 146 [123-169] ml/100 g/min，p = 0.015）和髓质（28 [18-47] vs. 47 [38-73] ml/100 g/min，p = 0.03）的局部灌注减少。两组的肾静脉饱和度相似（72% [64-75] vs. 72% [63-84]，ns.），皮质局部氧合（R2*）也是如此（17 [16-19] vs. 17 [16-18] l/s，ns.）和髓质（29 [24-39] vs. 27 [23-29] l/s，ns.）。在患有阿基的重症COVID-19患者中，与未患有阿基的类似患者相比，总肾血流量、皮质肾血流量和髓质肾血流量减少，而在这种情况下，肾氧合没有明显差异。试验注册ClinicalTrials ID：NCT 02765191，于2014年5月6日注册，于2020年5月7日更新。在线版本包含补充材料，可通过10.1186/s13054-022-04132-8获得。
Renal hypoperfusion has been suggested to contribute to the development of acute kidney injury (AKI) in critical COVID-19. However, limited data exist to support this. We aim to investigate the differences in renal perfusion, oxygenation and water diffusion using multiparametric magnetic resonance imaging in critically ill COVID-19 patients with and without AKI. A prospective case–control study where patients without prior kidney disease treated in intensive care for respiratory failure due to COVID-19 were examined. Kidney Disease: Improving Global Outcomes Creatinine criteria were used for group allocation. Main comparisons were tested using Mann–Whitney U test. Nineteen patients were examined, ten with AKI and nine without AKI. Patients with AKI were examined in median 1 [0–2] day after criteria fulfillment. Age and baseline Plasma-Creatinine were similar in both groups. Total renal blood flow was lower in patients with AKI compared with patients without (median 645 quartile range [423–753] vs. 859 [746–920] ml/min, p = 0.037). Regional perfusion was reduced in both cortex (76 [51–112] vs. 146 [123–169] ml/100 g/min, p = 0.015) and medulla (28 [18–47] vs. 47 [38–73] ml/100 g/min, p = 0.03). Renal venous saturation was similar in both groups (72% [64–75] vs. 72% [63–84], ns.), as was regional oxygenation (R2*) in cortex (17 [16–19] vs. 17 [16–18] 1/s, ns.) and medulla (29 [24–39] vs. 27 [23–29] 1/s, ns.). In critically ill COVID-19 patients with AKI, the total, cortical and medullary renal blood flows were reduced compared with similar patients without AKI, whereas no differences in renal oxygenation were demonstrable in this setting. Trial registration ClinicalTrials ID: NCT02765191, registered May 6 2014 and updated May 7 2020. The online version contains supplementary material available at 10.1186/s13054-022-04132-8.
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影响因子：
15.1
作者：
Fenhammar, Johan;Rundgren, Mats;Frithiof, Robert
通讯作者：
Frithiof, Robert
影响因子：
3.9
作者：
Silver SA;Beaubien-Souligny W;Shah PS;Harel S;Blum D;Kishibe T;Meraz-Munoz A;Wald R;Harel Z
通讯作者：
Harel Z
DOI：
10.1152/ajprenal.00311.2020
发表时间：
2020-12-01
影响因子：
4.2
作者：
Eckerbom，Per;Hansell，Peter;Liss，Per
通讯作者：
Liss，Per
影响因子：
6.3
作者：
Haddock, Bryan;Larsson, Henrik B. W.;Andersen, Ulrik B.
通讯作者：
Andersen, Ulrik B.
DOI：
10.1152/ajprenal.00575.2013
发表时间：
2014-03-01
影响因子：
4.2
作者：
Zhang, Jeff L.;Morrell, Glen;Lee, Vivian S.
通讯作者：
Lee, Vivian S.