Chronic kidney disease is a key risk factor for severe COVID-19: a call to action by the ERA-EDTA.
Chronic kidney disease is a key risk factor for severe COVID-19: a call to action by the ERA-EDTA.
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DOI：
10.1093/ndt/gfaa314
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发表时间：
2021-01-01
期刊：
影响因子：
--
通讯作者：
ERACODA Working Group
中科院分区：
文献类型：
--
作者：
ERA-EDTA Council;ERACODA Working Group
自2020年1月首次报告严重冠状病毒病以来，糖尿病、高血压和心血管疾病已被列为2019年严重冠状病毒病(新冠肺炎)的危险因素。然而，该报告没有提到慢性肾脏疾病(CKD)，也没有提供估计的肾小球滤过率(EGFR)或蛋白尿的相关性的信息。随着疾病在全球蔓延，出现了关于更大人口的信息，风险因素的粒度更大。最近发表的OpenSAFELY项目分析了1700万名患者中与新冠肺炎死亡相关的因素。出现的情况与最初的报告大不相同。例如，高血压不是新冠肺炎死亡的独立危险因素[调整后的风险比为0.89]，但肾脏疾病非常重要。透析(AHR3.69)、器官移植(AHR3.53)和慢性肾脏病(对于患有EGFR <的患者的AHR2.52；30 毫升/分钟/1.73m2)是与新冠肺炎死亡风险最高相关的四种合并症中的三种。与CKD 4和5期相关的风险高于与糖尿病(AHR范围1.31-1.95，取决于血糖控制)或慢性心脏病(AHR 1.17)相关的风险。在最近的另一份出版物《全球疾病负担协作》中指出，在全球范围内，慢性肾脏病是严重新冠肺炎最普遍的风险因素。此外，与普通人群相比，慢性肾脏病患者新冠肺炎死亡率的危险因素分布似乎不同。慢性肾脏病的高患病率，再加上慢性肾脏病患者死于新冠肺炎的风险增加，迫切需要对这类患者采取行动。本文定义了基本行动要点(在方框1中总结)，其中包括倡导将慢性肾脏病患者纳入临床试验，测试药物和疫苗预防严重新冠肺炎的疗效。
Diabetes, hypertension and cardiovascular disease have been listed as risk factors for severe coronavirus disease 2019 (COVID-19) since the first report of the disease in January 2020. However, this report did not mention chronic kidney disease (CKD) nor did it provide information on the relevance of estimated glomerular filtration rate (eGFR) or albuminuria. As the disease spread across the globe, information on larger populations with greater granularity on risk factors emerged. The recently published OpenSAFELY project analysed factors associated with COVID-19 death in 17 million patients. The picture that arose differs significantly from initial reports. For example, hypertension is not an independent risk factor for COVID-19 death [adjusted hazard ratio (aHR) 0.89], but renal disease very much is. Dialysis (aHR 3.69), organ transplantation (aHR 3.53) and CKD (aHR 2.52 for patients with eGFR <30 mL/min/1.73 m2) represent three of the four comorbidities associated with the highest mortality risk from COVID-19. The risk associated with CKD Stages 4 and 5 is higher than the risk associated with diabetes mellitus (aHR range 1.31–1.95, depending upon glycaemic control) or chronic heart disease (aHR 1.17). In another recent publication, the Global Burden of Disease collaboration identified that worldwide, CKD is the most prevalent risk factor for severe COVID-19. Moreover, the distribution of risk factors for COVID-19 mortality appears to be different in patients with CKD when compared with the general population. The high prevalence of CKD in combination with the elevated risk of mortality from COVID-19 in CKD necessitates urgent action for this group of patients. This article defines essential action points (summarized in Box 1), among which is advocating the inclusion of CKD patients in clinical trials testing the efficacy of drugs and vaccines to prevent severe COVID-19.
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DOI：
10.1016/s0140-6736(18)31694-5
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
Foreman KJ;Marquez N;Dolgert A;Fukutaki K;Fullman N;McGaughey M;Pletcher MA;Smith AE;Tang K;Yuan CW;Brown JC;Friedman J;He J;Heuton KR;Holmberg M;Patel DJ;Reidy P;Carter A;Cercy K;Chapin A;Douwes-Schultz D;Frank T;Goettsch F;Liu PY;Nandakumar V;Reitsma MB;Reuter V;Sadat N;Sorensen RJD;Srinivasan V;Updike RL;York H;Lopez AD;Lozano R;Lim SS;Mokdad AH;Vollset SE;Murray CJL
通讯作者：
Murray CJL
影响因子：
4.6
作者：
Rincon, Abraham;Moreso, Francesc;Ramos, Rosa
通讯作者：
Ramos, Rosa
影响因子：
5.5
作者：
Levin, Adeera;Stevens, Paul E.
通讯作者：
Stevens, Paul E.
影响因子：
44.5
作者：
Holman, Naomi;Knighton, Peter;Valabhji, Jonathan
通讯作者：
Valabhji, Jonathan
影响因子：
15.8
作者：
Kolhe NV;Fluck RJ;Selby NM;Taal MW
通讯作者：
Taal MW