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新冠肺炎确诊患者的肾功能特征:一项观察性研究。

Characteristics of Renal Function in Patients Diagnosed With COVID-19: An Observational Study.

作者信息

Hong Xu-Wei, Chi Ze-Pai, Liu Guo-Yuan, Huang Hong, Guo Shun-Qi, Fan Jing-Ru, Lin Xian-Wei, Qu Liao-Zhun, Chen Rui-Lie, Wu Ling-Jie, Wang Liang-Yu, Zhang Qi-Chuan, Wu Su-Wu, Pan Ze-Qun, Lin Hao, Zhou Yu-Hua, Zhang Yong-Hai

机构信息

Department of Urology, Shantou Central Hospital, Shantou, China.

Department of Emergency, Shantou Central Hospital, Shantou, China.

出版信息

Front Med (Lausanne). 2020 Jul 10;7:409. doi: 10.3389/fmed.2020.00409. eCollection 2020.

Abstract

The aim of the study was to analyze the characteristics of renal function in patients diagnosed with COVID-19. In this retrospective, single-center study, we included all confirmed cases of COVID-19 in a tertiary hospital in Guangdong, China from January 20, 2020 to March 20, 2020. Blood and urine laboratory findings related to renal function were summarized, and the estimated glomerular filtration rate (eGFR) and endogenous creatinine clearance (Ccr) were also calculated to assess the renal function. A total of 12 admitted hospital patients were diagnosed with COVID-19, included 3 severe cases, and 9 common cases. Serum creatinine (Scr) was not abnormally elevated in all of the patients, and blood urea nitrogen (BUN) was abnormally elevated in only 25.0% of the patients. However, compared with the recovery period, the patient's Scr and BUN increased significantly in peak of disease (p-scr = 0.002 & p-bun < 0.001). By observing the fluctuations in Scr and BUN from admission to recovery, it was found that the peak of Scr and BUN appeared within the first 14 day of the course of the disease. Urinary microprotein detection indicated that the abnormally elevated rates of urine microalbumin (UMA), α1-microglobulin (A1M), urine immunoglobulin-G (IGU), and urine transferring (TRU) standardized by urinary creatinine in peak of disease were 41.7, 41.7, 50.0, and 16.7%, respectively. The abnormal rates of the calculated eGFR and Ccr were 66.7 and 41.7%. Scr and BUN were generally increased during the course of COVID-19. Detection of urinary microproteins and application of multiple indicators assessment could be helpful for discovering abnormal renal function in patients with COVID-19. However, the evidence is limited due to the small sample size and observational nature. Additional studies, especially large prospective cohort studies, are required to confirm these findings.

摘要

本研究的目的是分析新型冠状病毒肺炎(COVID-19)确诊患者的肾功能特征。在这项回顾性单中心研究中,我们纳入了2020年1月20日至2020年3月20日期间中国广东省一家三级医院所有确诊的COVID-19病例。总结了与肾功能相关的血液和尿液实验室检查结果,并计算了估计肾小球滤过率(eGFR)和内生肌酐清除率(Ccr)以评估肾功能。共有12例住院患者被诊断为COVID-19,其中包括3例重症病例和9例普通病例。所有患者的血清肌酐(Scr)均未异常升高,仅25.0%的患者血尿素氮(BUN)异常升高。然而,与恢复期相比,患者的Scr和BUN在疾病高峰期显著升高(p-Scr = 0.002,p-BUN < 0.001)。通过观察从入院到康复期间Scr和BUN的波动情况,发现Scr和BUN的峰值出现在病程的前14天内。尿微量蛋白检测表明,疾病高峰期尿微量白蛋白(UMA)、α1-微球蛋白(A1M)、尿免疫球蛋白-G(IGU)和尿转铁蛋白(TRU)经尿肌酐标准化后的异常升高率分别为41.7%、41.7%、50.0%和16.7%。计算得到的eGFR和Ccr的异常率分别为66.7%和41.7%。在COVID-19病程中,Scr和BUN总体上有所升高。检测尿微量蛋白并应用多种指标进行评估有助于发现COVID-19患者的肾功能异常。然而,由于样本量小且为观察性研究,证据有限。需要更多的研究,尤其是大型前瞻性队列研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a62/7365839/30fad3833299/fmed-07-00409-g0001.jpg

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