Xiao Guanhua, Hu Hongbin, Wu Feng, Sha Tong, Zeng Zhenhua, Huang Qiaobing, Li Haijun, Han Jiafa, Song Wenhong, Chen Zhongqing, Cai Shumin
Department of Respiratory and Critical Care Medicine, Southern Medical University, Guangzhou 510515, China.
Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2021 Feb 25;41(2):157-163. doi: 10.12122/j.issn.1673-4254.2021.02.01.
To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19).
This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis.
Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI.
AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.
评估2019冠状病毒病（COVID-19）患者急性肾损伤（AKI）的预测因素及预后。
本回顾性观察性研究纳入了2020年1月5日至3月8日在汉口医院确诊为COVID-19的患者。我们采用单因素回归分析评估AKI与患者人口统计学、生化参数及临床预后的相关性。
分析共纳入287例COVID-19患者，其中55例发生AKI，232例未发生AKI。与未发生AKI的患者相比，发生AKI的患者年龄更大，以男性为主，更易出现缺氧，且更易合并高血压和脑血管疾病。发生AKI的患者白细胞、D-二聚体、天冬氨酸转氨酶、总胆红素、肌酸激酶、乳酸脱氢酶、降钙素原、C反应蛋白水平更高，高钾血症患病率更高，淋巴细胞计数更低，胸部计算机断层扫描评分更高。1期AKI的发生率为14.3%，2期或3期AKI的发生率为4.9%。发生AKI的患者死亡率远高于未发生AKI的患者。
AKI是COVID-19的重要并发症。高龄、男性、多种基础合并症、淋巴细胞减少、感染指标升高、D-二聚体升高以及心肝功能受损均为AKI的潜在危险因素。进展为2期或3期AKI的COVID-19合并AKI患者死亡率较高。预防AKI及监测肾功能对COVID-19患者的治疗至关重要。
