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中重度新型冠状病毒肺炎患者的急性肾损伤:两家大学医院的报告

Acute kidney injury in moderate and severe COVID-19 patients: Report of two university hospitals.

作者信息

Radulescu Daniela, Tuta Liliana-Ana, David Cristiana, Bogeanu Carmen, Onofrei Simona Daniela, Stepan Elena, Cuiban Elena, Ciofalca Andreea, Feier Larisa Florina, Pana Camelia, Nutu Magda-Cristina, Vacaroiu Ileana Adela

机构信息

Clinical Department No. 3, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Department of Nephrology and Dialysis, 'Sf. Ioan' Emergency Clinical Hospital, 421422 Bucharest, Romania.

出版信息

Exp Ther Med. 2022 Jan;23(1):37. doi: 10.3892/etm.2021.10959. Epub 2021 Nov 10.

Abstract

Acute kidney injury (AKI) is one of the most severe complications of SARS-CoV-2 infection. In a retrospective study, we aimed to describe the influence of COVID-19-related factors on the severity, outcome and timing of AKI in 268 patients admitted in two large COVID-19-designated university hospitals over a period of 6 months. In the univariate analysis, there was a significant relationship between KDIGO stage and the extension of COVID-19 pneumonia on computed tomography (CT), need for oxygen supplementation, serum levels of ferritin, interleukin-6, and procalcitonin, but none of these variables had a value for predicting KDIGO stage in multinomial regression. The odds of recovery of renal function were significantly diminished by d-dimer values. Lack of immunomodulatory treatment was found to be correlated with increased need for renal replacement therapy (RRT). Compared with AKI at admission, hospital-acquired AKI was predicted by the severity of lung damage on CT, evolved more frequently with incomplete recovery of renal function, and was significantly associated with antiviral therapy.

摘要

急性肾损伤(AKI)是新型冠状病毒肺炎(SARS-CoV-2)感染最严重的并发症之一。在一项回顾性研究中,我们旨在描述268例在两家大型新冠肺炎定点大学医院住院6个月的患者中,与新冠肺炎相关的因素对AKI严重程度、结局及发生时间的影响。单因素分析显示,肾脏疾病改善全球预后(KDIGO)分期与新冠肺炎肺炎在计算机断层扫描(CT)上的范围、吸氧需求、血清铁蛋白、白细胞介素-6及降钙素原水平之间存在显著相关性,但在多因素回归中,这些变量均无预测KDIGO分期的价值。D-二聚体水平会显著降低肾功能恢复的几率。发现缺乏免疫调节治疗与肾脏替代治疗(RRT)需求增加相关。与入院时即发生的AKI相比,医院获得性AKI可通过CT上肺部损伤的严重程度预测,肾功能恢复不完全的情况更常见,且与抗病毒治疗显著相关。

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