Nephrology, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China.
Ultrasound, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, Chongqing, China.
BMJ Open. 2020 Nov 10;10(11):e042573. doi: 10.1136/bmjopen-2020-042573.
To analyse the incidence, risk factors and impact of acute kidney injury (AKI) on the prognosis of patients with COVID-19.
Meta-analysis.
PubMed, Embase, CNKI and MedRxiv of Systematic Reviews from 1 January 2020 to 15 May 2020.
Studies examining the following demographics and outcomes were included: patients' age; sex; incidence of and risk factors for AKI and their impact on prognosis; COVID-19 disease type and incidence of continuous renal replacement therapy (CRRT) administration during COVID-19 infection.
A total of 79 research articles, including 49 692 patients with COVID-19, met the systemic evaluation criteria. The mortality rate and incidence of AKI in patients with COVID-19 in China were significantly lower than those in patients with COVID-19 outside China. A significantly higher proportion of patients with COVID-19 from North America were aged ≥65 years and also developed AKI. European patients with COVID-19 had significantly higher mortality and a higher CRRT rate than patients from other regions. Further analysis of the risk factors for COVID-19 combined with AKI showed that age ≥60 years and severe COVID-19 were independent risk factors for AKI, with an OR of 3.53, 95% CI (2.92-4.25) and an OR of 6.07, 95% CI (2.53-14.58), respectively. The CRRT rate in patients with severe COVID-19 was significantly higher than in patients with non-severe COVID-19, with an OR of 6.60, 95% CI (2.83-15.39). The risk of death in patients with COVID-19 and AKI was significantly increased, with an OR of 11.05, 95% CI (9.13-13.36).
AKI was a common and serious complication of COVID-19. Older age and having severe COVID-19 were independent risk factors for AKI. The risk of in-hospital death was significantly increased in patients with COVID-19 complicated by AKI.
分析 COVID-19 患者急性肾损伤（AKI）的发生率、危险因素及其对预后的影响。
荟萃分析。
2020 年 1 月 1 日至 2020 年 5 月 15 日期间，PubMed、Embase、CNKI 和 MedRxiv 中的系统评价数据库。
纳入研究患者的年龄、性别、AKI 的发生率、危险因素及其对预后的影响、COVID-19 疾病类型和 COVID-19 感染期间持续肾脏替代治疗（CRRT）的应用。
共有 79 篇研究文章，包括 49692 例 COVID-19 患者，符合系统评价标准。中国 COVID-19 患者的死亡率和 AKI 发生率明显低于中国以外地区的 COVID-19 患者。来自北美的 COVID-19 患者年龄≥65 岁且发生 AKI 的比例明显更高。欧洲 COVID-19 患者的死亡率和 CRRT 使用率明显高于其他地区。对 COVID-19 合并 AKI 的危险因素进行进一步分析表明，年龄≥60 岁和重症 COVID-19 是 AKI 的独立危险因素，OR 值分别为 3.53（95%CI：2.92-4.25）和 6.07（95%CI：2.53-14.58）。重症 COVID-19 患者的 CRRT 使用率明显高于非重症 COVID-19 患者，OR 值为 6.60（95%CI：2.83-15.39）。COVID-19 合并 AKI 患者的死亡风险显著增加，OR 值为 11.05（95%CI：9.13-13.36）。
AKI 是 COVID-19 的常见且严重的并发症。年龄较大和患有重症 COVID-19 是 AKI 的独立危险因素。COVID-19 合并 AKI 患者住院死亡风险显著增加。
