Prevalence, Characteristics, Risk Factors, and Outcomes of Invasively Ventilated COVID-19 Patients with Acute Kidney Injury and Renal Replacement Therapy
Prevalence, Characteristics, Risk Factors, and Outcomes of Invasively Ventilated COVID-19 Patients with Acute Kidney Injury and Renal Replacement Therapy
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DOI：
10.1159/000508657
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发表时间：
2021-01-01
影响因子：
3
通讯作者：
Zangrillo, Alberto
中科院分区：
文献类型：
--
作者：
Fominskiy, Evgeny, V;Scandroglio, Anna Mara;Zangrillo, Alberto
背景：在西方医疗系统中，没有关于侵袭性通风冠状病毒病2019(新冠肺炎)患者的急性肾损伤和连续性肾脏替代治疗的信息。目的：研究新冠肺炎有创机械通气患者急性呼吸窘迫综合征和慢性肾功能衰竭的发生率、特点、危险因素及转归。方法：在意大利米兰的一家三级保健医院进行观察性研究。结果：99例患者中72例(75.0%)发生AKI，17例(17.7%)接受CRRT治疗。大多数患者发生1期AKI(33例(45.8%))，15例(20.8%)发展为2期AKI，24例(33.4%)发展为3期AKI。发生AKI或在最近一次随访时需要CRRT的患者年龄较大，在接受CRRT治疗的患者中，有更大比例的患者已有CKD。AKI组和CRRT组的住院死亡率分别为38.9%和52.9%。结论：在有创机械通气的新冠肺炎患者中，急性心肌梗死非常常见，CRRT的应用也很普遍。两者都有很高的住院死亡率。
Background: There is no information on acute kidney injury (AKI) and continuous renal replacement therapy (CRRT) among invasively ventilated coronavirus disease 2019 (COVID-19) patients in Western healthcare systems. Objective: To study the prevalence, characteristics, risk factors and outcome of AKI and CRRT among invasively ventilated COVID-19 patients. Methods: Observational study in a tertiary care hospital in Milan, Italy. Results: Among 99 patients, 72 (75.0%) developed AKI and 17 (17.7%) received CRRT. Most of the patients developed stage 1 AKI (33 [45.8%]), while 15 (20.8%) developed stage 2 AKI and 24 (33.4%) a stage 3 AKI. Patients who developed AKI or needed CRRT at latest follow-up were older, and among CRRT treated patients a greater proportion had preexisting CKD. Hospital mortality was 38.9% for AKI and 52.9% for CRRT patients. Conclusions: Among invasively ventilated COVID-19 patients, AKI is very common and CRRT use is common. Both carry a high risk of in-hospital mortality.