Department of Internal Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Diabetes Res. 2021 Jan 6;2021:6666086. doi: 10.1155/2021/6666086. eCollection 2021.
The risk factors for acute kidney injury (AKI) development in patients with diabetes hospitalized for COVID-19 have not been fully studied yet. In this study, we aimed to estimate the rate of AKI among the hospitalized population with COVID-19 and to identify the risk factors associated with AKI among patients with diabetes. This retrospective cohort study included 254 patients (127 with diabetes and 127 without diabetes) who were admitted for COVID-19 to a tertiary hospital in Tehran, Iran, between February and May 2020. Clinical characteristics and outcomes, radiological findings, and laboratory data, including data on AKI, hematuria, and proteinuria were recorded and analyzed.
Of 254 patients, 142 (55.9%) were male and the mean (± SD) age was 65.7 years (±12.5). In total, 58 patients (22.8%) developed AKI during hospitalization, of whom 36 patients had diabetes ( = 0.04); most patients (74.1%) had stage 1 or 2 AKI. Also, 8 patients (13.8%) required renal replacement therapy (RRT) after developing AKI. Regardless of diabetes status, patients who developed AKI had significantly higher mortality rates compared with patients who did not develop AKI ( = 0.02). Hematuria and proteinuria were observed in 38.1% and 55% of patients, respectively. Multivariate analysis showed that invasive mechanical ventilation, proteinuria, HBA1c level, history of cardiovascular disease, and use of statins were independent risk factors for AKI development in patients with diabetes.
Results of this study showed that AKI develops in a considerable percentage of patients with COVID-19, especially in those with diabetes, and is significantly associated with mortality.
患有糖尿病并因 COVID-19 住院的患者发生急性肾损伤（AKI）的风险因素尚未得到充分研究。在这项研究中，我们旨在估计 COVID-19 住院人群中 AKI 的发生率，并确定糖尿病患者发生 AKI 的相关风险因素。这项回顾性队列研究纳入了 2020 年 2 月至 5 月期间在伊朗德黑兰一家三级医院因 COVID-19 住院的 254 名患者（127 名患有糖尿病，127 名无糖尿病）。记录并分析了临床特征和结局、影像学发现以及实验室数据，包括 AKI、血尿和蛋白尿的数据。
254 名患者中，142 名（55.9%）为男性，平均（±SD）年龄为 65.7 岁（±12.5）。共有 58 名（22.8%）患者在住院期间发生 AKI，其中 36 名患者患有糖尿病（=0.04）；大多数患者（74.1%）患有 1 期或 2 期 AKI。此外，8 名（13.8%）发生 AKI 后需要肾脏替代治疗（RRT）。无论是否患有糖尿病，发生 AKI 的患者死亡率均明显高于未发生 AKI 的患者（=0.02）。血尿和蛋白尿分别在 38.1%和 55%的患者中观察到。多变量分析显示，有创机械通气、蛋白尿、糖化血红蛋白（HbA1c）水平、心血管疾病史和他汀类药物的使用是糖尿病患者发生 AKI 的独立危险因素。
本研究结果表明，COVID-19 患者中相当一部分患者会发生 AKI，尤其是糖尿病患者，且 AKI 与死亡率显著相关。
