新型冠状病毒肺炎患者的急性肾损伤与肾脏替代治疗：系统评价和荟萃分析。

Acute kidney injury and renal replacement therapy in COVID-19 patients: A systematic review and meta-analysis.

机构信息

Department of Nephrology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.

Department of Nephrology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Nephrology, The Shenzhen Baoan Shiyan People's Hospital, Shenzhen, Guangdong 518005, China.

出版信息

Int Immunopharmacol. 2021 Jan;90:107159. doi: 10.1016/j.intimp.2020.107159. Epub 2020 Nov 3.

PURPOSE

Reported rates of acute kidney injury (AKI) have varied significantly among studies of coronavirus disease 2019 (COVID-19) published to date. The present meta-analysis was conducted to gain clarity regarding AKI incidence and renal replacement therapy (RRT) use in COVID-19 patients.

METHODS

The PubMed, Embase, Web of Science, medRxiv, and bioRxiv databases were systematically searched for COVID-19-related case reports published through 25 July 2020. Pooled analyses were conducted using R.

RESULTS

The pooled incidence of AKI in 51 studies including 21,531 patients was 12.3% (95% CI 9.5-15.6%), with higher rates of 38.9% in 290 transplant patients (95% CI 27.3-51.9%), 39.0% in 565 ICU patients (95% CI 23.2-57.6%) and 42.0% among 1745 deceased patients (95% CI 30.3-54.7%). RRT usage was reported in 39 studies of 17,664 patients, with an overall pooled use of 5.4% (95% CI 4.0-7.1%), with higher rates of 15.6% in 117 transplant patients (95%CI 9.9-23.8%) and 16.3% in 776 ICU patients (95% CI 11.1-23.3%).

CONCLUSION

AKI and RRT use among COVID-19 patients represent a major public health concern, and early and appropriate intervention should be called upon to improve the prognosis of patients suffering from AKI.

目的

迄今为止，已发表的关于 2019 年冠状病毒病（COVID-19）的研究报告中，急性肾损伤（AKI）的报告率差异很大。本荟萃分析旨在明确 COVID-19 患者 AKI 的发生率和肾脏替代治疗（RRT）的使用情况。

方法

通过系统检索 PubMed、Embase、Web of Science、medRxiv 和 bioRxiv 数据库，检索截至 2020 年 7 月 25 日发表的与 COVID-19 相关的病例报告。使用 R 进行汇总分析。

结果

51 项研究共纳入 21531 例患者，AKI 的总发生率为 12.3%（95%CI 9.5-15.6%），其中 290 例移植患者的 AKI 发生率较高，为 38.9%（95%CI 27.3-51.9%），565 例 ICU 患者为 39.0%（95%CI 23.2-57.6%），1745 例死亡患者为 42.0%（95%CI 30.3-54.7%）。39 项研究报告了 17664 例患者的 RRT 使用情况，总体 RRT 使用的汇总率为 5.4%（95%CI 4.0-7.1%），117 例移植患者的 RRT 使用率较高，为 15.6%（95%CI 9.9-23.8%），776 例 ICU 患者为 16.3%（95%CI 11.1-23.3%）。