Aroca-Martínez Gustavo, Musso Carlos G, Avendaño-Echavez Lil, Vélez-Verbel María, Chartouni-Narvaez Stefani, Hernandez Sandra, Hinojosa-Vidal Mauricio Andres, Espitaleta Zilac, Cadena-Bonfanti Andrés
Universidad Simón Bolívar, Faculdade de Ciências da Saúde, Barranquilla, Colômbia.
Clínica de la Costa, Departamento de Nefrologia, Barranquilla, Colômbia.
J Bras Nefrol. 2022 Apr-Jun;44(2):155-163. doi: 10.1590/2175-8239-JBN-2021-0161.
This article describes the main differences between COVID-19-induced acute kidney injury (AKI-COVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKI-CKD) treated in a high complexity clinic in Barranquilla (Colombia).
The patients included in this study (n: 572) were those with a positive diagnosis of COVID-19 confirmed by detection of a positive PCR for SARS-CoV-2. Of these patients, 188 developed AKI during their hospital stay. Patients' epidemiological data, serum parameters, and clinical frailty status were recorded. Statistical analysis and comparison among AKI-NRF, AKI-CKD, and non-AKI patients were performed.
The incidence of COVID-19-induced AKI was 33%, with the majority classified as AKIN 1, 16% requiring renal replacement therapy, and AKI-COVID19 mortality of 68%. A significantly higher prevalence of hypertension, cardiac disease, and serum reactive C-protein and lower albumin values in AKI-CKD patients was recorded. Mortality rate, invasive ventilation requirement, and D-dimer levels were significantly higher in AKI-NRF patients.
Different clinical patterns between AKI-NRF and AKI-CKD were documented.
本文描述了在巴兰基亚（哥伦比亚）一家高复杂性诊所接受治疗的既往肾功能正常的患者（急性肾损伤-新冠19，AKI-NRF）和慢性肾脏病患者（急性肾损伤-慢性肾脏病，AKI-CKD）中，新冠病毒感染所致急性肾损伤（AKI-COVID19）的主要差异。
本研究纳入的患者（n = 572）为经检测SARS-CoV-2的聚合酶链反应（PCR）呈阳性而确诊为新冠病毒感染的患者。在这些患者中，188例在住院期间发生了急性肾损伤。记录患者的流行病学数据、血清参数和临床虚弱状态，并对急性肾损伤-肾功能正常组、急性肾损伤-慢性肾脏病组和非急性肾损伤患者进行统计分析和比较。
新冠病毒感染所致急性肾损伤的发生率为33%，大多数分类为急性肾损伤网络（AKIN）1期，16%的患者需要肾脏替代治疗，急性肾损伤-新冠19的死亡率为68%。记录到急性肾损伤-慢性肾脏病患者中高血压、心脏病、血清反应性C蛋白的患病率显著更高，白蛋白值更低。急性肾损伤-肾功能正常组患者的死亡率、有创通气需求和D-二聚体水平显著更高。
记录到急性肾损伤-肾功能正常组和急性肾损伤-慢性肾脏病组之间存在不同的临床模式。
