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COVID-19 患者肾功能异常的频率:来自发展中国家的三级保健经验。

Frequency of deranged renal profile in patients with COVID-19: Tertiary Care Experience from a developing country.

机构信息

Department of Internal Medicine, Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan.

Department of Nephrology, Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Saudi J Kidney Dis Transpl. 2021 Mar-Apr;32(2):377-386. doi: 10.4103/1319-2442.335450.

Abstract

Coronavirus disease-2019 (COVID-19) is a global pandemic, also affecting Pakistan with its first case reported on February 26, 2020. Since then, it has been declared a pandemic by the World Health Organization. Our study aimed to evaluate the renal derangements associated with COVID-19 infection in our population. A retrospective, observational study was conducted to include all the admitted patients having COVID-19 positive, and evaluated those for derangements of renal function (n = 362). Out of the 362 patients, 229were admitted in the ward, 133 were in intensive care unit (ICU), 258 of them recovered, while 104 deaths reported. At admission, the renal profile was deranged in almost one-half of ICU admissions and mortalities which increased to two-third during the hospital stay, with around 80% of deaths reported with increased urea and creatinine levels. Among the deceased patients, around one-third of the mortalities developed renal profile derangements during the hospital stay although they were admitted with a normal renal profile. An estimated glomerular filtration rate showed a mean increase of 13.37 mL/min/1.73 m during the hospital stay of surviving patients, while a decline of 19.92 in nonsurviving patients. A hazard ratio of 3.293 (P <0.001) for admitting serum urea and 3.795 (P = 0.009) at discharge and for serum creatinine at 5.392 (P <0.001) on discharge was associated significantly with mortality. Kaplan-Meier plot showed a significant decline in days of survival with deranged urea and creatinine (P <0.001). The deranged renal function in COVID-19 patients is associated with an increased number of ICU admissions as well as mortalities.

摘要

新型冠状病毒病(COVID-19)是一种全球性大流行病,也影响到巴基斯坦,其首例病例于 2020 年 2 月 26 日报告。自那时以来,世界卫生组织已宣布该疾病为大流行病。我们的研究旨在评估 COVID-19 感染相关的肾脏损伤。本研究是一项回顾性观察性研究,纳入了所有 COVID-19 阳性住院患者,并对肾功能异常患者进行了评估(n = 362)。在 362 例患者中,229 例在普通病房住院,133 例在重症监护病房(ICU)住院,258 例患者治愈出院,104 例患者死亡。在入院时,几乎一半 ICU 患者和死亡患者的肾功能异常,住院期间这一比例增加到三分之二,80%的死亡患者尿素和肌酐水平升高。在死亡患者中,尽管在入院时肾功能正常,但约三分之一的患者在住院期间出现肾功能异常。估计肾小球滤过率显示,存活患者住院期间平均增加 13.37 mL/min/1.73 m,而未存活患者则下降 19.92 mL/min/1.73 m。入院时血清尿素的风险比为 3.293(P <0.001),出院时血清尿素和肌酐的风险比为 3.795(P = 0.009),出院时血清肌酐的风险比为 5.392(P <0.001),与死亡率显著相关。生存的 Kaplan-Meier 曲线显示,尿素和肌酐异常的患者生存天数显著减少(P <0.001)。COVID-19 患者的肾功能异常与 ICU 住院人数和死亡率增加相关。

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