The Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Adult Patients with Coronavirus Disease 2019
The Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Adult Patients with Coronavirus Disease 2019
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DOI：
10.2215/cjn.04650420
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发表时间：
2020-10-07
影响因子：
9.8
通讯作者：
Xu, Gang
中科院分区：
文献类型：
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作者：
Cheng, Yichun;Luo, Ran;Xu, Gang
背景与目的自2019年12月以来，中国发生了冠状病毒病2019(新冠肺炎)疫情，并在全球范围内迅速蔓延。然而，新冠肺炎上关于AKI的信息很少。我们的目的是评估成人新冠肺炎患者急性心肌梗死的发生率、危险因素和预后。设计、背景、参与者和测量：这是一项对某三级教学医院收治的1392例急性心肌梗死患者进行的回顾性队列研究。临床特征和实验室数据从电子住院和实验室数据库中提取。根据2012年肾脏疾病：改善全球预后标准对AKI进行定义和分期。结果1392例患者中，7%(99/1392)的患者在住院期间发生AKI，其中40%(40/99)发生在入院后1周内。与AKI相关的高风险因素包括严重疾病(优势比[OR]，2.25；95%可信区间[CI]，1.37至3.67)，较高的基线血肌酐(OR，2.19；95%CI，1.17至4.11)，淋巴细胞减少(OR，1.99；95%CI，1.12至3.53)，以及D-二聚体水平升高(OR，2.68；95%CI，1.07至6.70)。AKI期1、2和3期患者的住院死亡率分别为62%、77%和80%。即使在调整混杂因素后，急性心肌梗死仍与住院死亡率相关(OR，5.12；95%CI，2.7~9.72)。结论急性心肌梗死在新冠肺炎患者中并不常见，但具有较高的住院死亡率。
Backgroundandobjectives SinceDecember 2019, coronavirusdisease 2019(COVID-19) outbreak occurred and has rapidly spread worldwide. However, little information is available about the AKI in COVID-19. We aimed to evaluate the incidence, risk factors, and prognosis of AKI in adult patients with COVID-19.Design, setting, participants, & measurements This was a retrospective cohort study of 1392 patients with COVID-19 admitted to a tertiary teaching hospital. Clinical characteristics and laboratory data were extracted from electronic hospitalization and laboratory databases. AKI was defined and staged according to the 2012 Kidney Disease: Improving Global Outcomes criteria. Risk factors for AKI and the association of AKI with in-hospital mortality were assessed.Results A total of 7%(99 of 1392) of patients developed AKI during hospitalization, 40%(40 of 99) of which occurred within 1 week of admission. Factors associated with a higher risk of AKI include severe disease (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.37 to 3.67), higher baseline serum creatinine (OR, 2.19; 95% CI, 1.17 to 4.11), lymphopenia (OR, 1.99; 95% CI, 1.12 to 3.53), and elevated D-dimer level (OR, 2.68; 95% CI, 1.07 to 6.70). The in-hospital mortality in patients with AKI stage 1, stage 2, and stage 3 was 62%, 77%, and 80%, respectively. AKI was associated with in-hospital mortality even after adjustment for confounders (OR, 5.12; 95% CI, 2.70 to 9.72).Conclusions AKI is uncommon but carries high in-hospital mortality in patients with COVID-19.