Decreasing Incidence of Acute Kidney Injury in Patients with COVID-19 Critical Illness in New York City.
Decreasing Incidence of Acute Kidney Injury in Patients with COVID-19 Critical Illness in New York City.
复制标题
纽约市Covid-19危重疾病患者急性肾脏损伤的发生率降低。
DOI：
10.1016/j.ekir.2021.01.036
复制
发表时间：
2021-04
影响因子：
6
通讯作者：
Horwitz LI
中科院分区：
文献类型：
--
作者：
Charytan DM;Parnia S;Khatri M;Petrilli CM;Jones S;Benstein J;Horwitz LI
来自美国的报告表明，急性肾损伤 (AKI) 经常使 2019 年冠状病毒病 (COVID-19) 并发，但对 AKI 风险和结果的了解并不完整。此外，在大流行期间肾脏结局是否发生变化尚不清楚。我们使用电子病历来识别 2020 年 3 月 2 日至 8 月 25 日期间入住纽约 3 家医院的患有或不患有 AKI 的 COVID-19 患者。结果包括总体 AKI 情况以及按入院周划分的情况、AKI 分期、新肾脏替代治疗 (RRT) 的要求、死亡率和肾功能恢复情况。使用逻辑回归来评估患者特征和结果的关联。在 4732 名入院患者中，1386 名 (29.3%) 患者患有 AKI。在 AKI 患者中，717 例 (51.7%) 患有 1 期疾病，132 例 (9.5%) 患有 2 期疾病，537 例 (38.7%) 患有 3 期疾病，237 例 (17.1%) 需要启动 RRT。 3 月份，1648 名患者中有 536 名 (32.5%) 出现 AKI，而 8 月份，87 名患者中有 15 名 (17.2%) 出现 AKI（每月趋势 P < 0.001），而 3 月份和 8 月份分别有 6.9% 和 0% 的入院患者需要启动 RRT。发生 AKI 的死亡率高于未发生 AKI 的死亡率（51.6% 比 8.6%），需要 RRT 的个体死亡率为 71.9%。然而，大多数住院后幸存的 AKI 患者 (77%) 恢复到基线肌酐 0.3 mg/dl 以内。在幸存出院的患者中，62% 停止了 RRT。 AKI 影响了很大一部分入院的 COVID-19 患者，并与高死亡率相关，特别是在需要 RRT 时。随着时间的推移，AKI 的发生率似乎正在下降，幸存者的肾功能通常会恢复。
Reports from the United States suggest that acute kidney injury (AKI) frequently complicates coronavirus disease 2019 (COVID-19), but understanding of AKI risks and outcomes is incomplete. In addition, whether kidney outcomes have evolved during the course of the pandemic is unknown. We used electronic medical records to identify patients with COVID-19 with and without AKI admitted to 3 New York Hospitals between March 2 and August 25, 2020. Outcomes included AKI overall and according to admission week, AKI stage, the requirement for new renal replacement therapy (RRT), mortality, and recovery of kidney function. Logistic regression was used to assess associations of patient characteristics and outcomes. Of 4732 admissions, 1386 (29.3%) patients had AKI. Among those with AKI, 717 (51.7%) had stage 1 disease, 132 (9.5%) had stage 2 disease, 537 (38.7%) had stage 3 disease, and 237 (17.1%) required RRT initiation. In March, 536 of 1648 (32.5%) patients developed AKI compared with 15 of 87 (17.2%) in August (P < 0.001 for monthly trend), whereas RRT initiation was required in 6.9% and 0% of admissions in March and August, respectively. Mortality was higher with than without AKI (51.6% vs. 8.6%) and was 71.9% in individuals requiring RRT. However, most patients with AKI who survived hospitalization (77%) recovered to within 0.3 mg/dl of baseline creatinine. Among those surviving to discharge, 62% discontinued RRT. AKI impacts a high proportion of admitted patients with COVID-19 and is associated with high mortality, particularly when RRT is required. AKI incidence appears to be decreasing over time and kidney function frequently recovers in those who survive.
登录
查看更多内容
COVID-19 肺炎患者的肾脏受累和早期预后
影响因子：
13.6
作者：
Pei, Guangchang;Zhang, Zhiguo;Xu, Gang
通讯作者：
Xu, Gang
影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
2.9
作者：
Hodgson LE;Sarnowski A;Roderick PJ;Dimitrov BD;Venn RM;Forni LG
通讯作者：
Forni LG
影响因子：
39
作者：
Gupta, Shruti;Hayek, Salim S.;Leaf, David E.
通讯作者：
Leaf, David E.
影响因子：
19.6
作者：
Cheng, Yichun;Luo, Ran;Xu, Gang
通讯作者：
Xu, Gang