慢性肾脏病与新发肾脏替代治疗对COVID-19患者预后的关联：一项荟萃分析。
The Association Between Chronic Kidney Disease and New Onset Renal Replacement Therapy on the Outcome of COVID-19 Patients: A Meta-analysis.
作者信息
Pranata Raymond, Supriyadi Rudi, Huang Ian, Permana Hikmat, Lim Michael Anthonius, Yonas Emir, Soetedjo Nanny Natalia M, Lukito Antonia Anna
机构信息
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
出版信息
Clin Med Insights Circ Respir Pulm Med. 2020 Sep 17;14:1179548420959165. doi: 10.1177/1179548420959165. eCollection 2020.
OBJECTIVE
The aim of the study was to evaluate the association between chronic kidney disease (CKD) and new onset renal replacement therapy (RRT) with the outcome of Coronavirus Disease 2019 (COVID-19) in patients.
METHODOLOGY
A systematic literature search from several databases was performed on studies that assessed CKD, use of RRT, and the outcome of COVID-19. The composite of poor outcome consisted of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care, and use of mechanical ventilator.
RESULTS
Nineteen studies with a total of 7216 patients were included. CKD was associated with increased composite poor outcome (RR 2.63 [1.33, 5.17], = .03; = 51%, = .01) and its subgroup, consisting of mortality (RR 3.47 [1.36, 8.86], = .009; = 14%, = .32) and severe COVID-19 (RR 2.89 [0.98, 8.46], = .05; = 57%, = .04). RRT was associated with increased composite poor outcome (RR 18.04 [4.44, 73.25], < .001; = 87%, < .001), including mortality (RR 26.02 [5.01, 135.13], < .001; = 60%, = .06), severe COVID-19 (RR 12.95 [1.93, 86.82], = .008; = 81%, < .001), intensive care (IC) (RR 14.22 [1.76, 114.62], < .01; = 0%, < .98), and use of mechanical ventilator (RR 34.39 [4.63, 255.51], < .0005).
CONCLUSION
CKD and new-onset RRT were associated with poor outcome in patients with COVID-19.
目的
本研究旨在评估慢性肾脏病（CKD）和新开始的肾脏替代治疗（RRT）与2019冠状病毒病（COVID-19）患者预后之间的关联。
方法
对多个数据库进行系统文献检索，纳入评估CKD、RRT使用情况以及COVID-19预后的研究。不良预后的综合指标包括死亡率、重症COVID-19、急性呼吸窘迫综合征（ARDS）、重症监护需求以及机械通气的使用。
结果
共纳入19项研究，总计7216例患者。CKD与不良预后综合指标增加相关（风险比[RR]2.63[1.33,5.17]，P = 0.03；I² = 51%，P = 0.01）及其亚组，包括死亡率（RR 3.47[1.36,8.86]，P = 0.009；I² = 14%，P = 0.32）和重症COVID-19（RR 2.89[0.98,8.46]，P = 0.05；I² = 57%，P = 0.04）。RRT与不良预后综合指标增加相关（RR 18.04[4.44,73.25]，P < 0.001；I² = 87%，P < 0.001），包括死亡率（RR 26.02[5.01,135.13]，P < 0.001；I² = 60%，P = 0.06）、重症COVID-19（RR 12.95[1.93,86.82]，P = 0.008；I² = 81%，P < 0.001）、重症监护（IC）（RR 14.22[1.76,114.62]，P < 0.01；I² = 0%，P < 0.98）以及机械通气的使用（RR 34.39[4.63,255.51]，P < 0.0005）。
结论
CKD和新开始的RRT与COVID-19患者的不良预后相关。
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