Iryaningrum Maria R, Supriyadi Rudi, Lawrensia Sherly, Henrina Joshua, Soetedjo Nanny Natalia M
Department of Internal Medicine, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
Indian J Nephrol. 2022 Jul-Aug;32(4):327-333. doi: 10.4103/ijn.ijn_293_21. Epub 2022 May 20.
Patients with kidney disease and COVID-19, whether on hemodialysis (HD) or not, have a higher risk of contracting COVID-19 accompanied by a higher mortality rate due to suppressed immune functions. Diabetes, one of the ubiquitous etiology of kidney disease, is also associated with a composite of poor outcomes.
Meta-analysis and meta-regression of 13 articles on COVID-19 patients with chronic kidney disease, with information on diabetes and mortality were performed using Review Manager 5.4 and OpenMetaAnalyst.
The meta-analysis of a pooled subject of 18,822 patients showed that the presence of diabetes in CKD patients with COVID-19 was associated with an increased risk of mortality (RR 1.41 (1.15, 1.72); < 0.001; I2 70%, < 0.001). Subgroup analysis showed that diabetes was not associated with mortality in the HD group (RR 1.27 (1.06, 1.54); = 0.01; I2 0%, = 0.70) but showed a significant association in the non-HD group (RR 1.66 (1.59, 1.73); < 0.001; I2 85%, < 0.001). Male gender ( = 0.070) contributed to the effect size differences (age: < 0.001; hypertension: = 0.007; CVD: < 0.001; lung disease: < 0.001).
Diabetes was associated with higher mortality risk among CKD patients, primarily those who did not need RRT.
患有肾脏疾病和新冠肺炎的患者，无论是否接受血液透析（HD），由于免疫功能受到抑制，感染新冠肺炎的风险更高，死亡率也更高。糖尿病是肾脏疾病普遍存在的病因之一，也与一系列不良后果相关。
使用Review Manager 5.4和OpenMetaAnalyst对13篇关于新冠肺炎合并慢性肾脏病患者的文章进行荟萃分析和荟萃回归，这些文章包含糖尿病和死亡率的信息。
对18822名患者的汇总分析表明，新冠肺炎合并慢性肾脏病患者中糖尿病的存在与死亡风险增加相关（风险比1.41（1.15，1.72）；P<0.001；I² 70%，P<0.001）。亚组分析表明，糖尿病与血液透析组的死亡率无关（风险比1.27（1.06，1.54）；P = 0.01；I² 0%，P = 0.70），但在非血液透析组中显示出显著相关性（风险比1.66（1.59，1.73）；P<0.001；I² 85%，P<0.001）。男性（P = 0.070）导致了效应量差异（年龄：P<0.001；高血压：P = 0.007；心血管疾病：P<0.001；肺部疾病：P<0.001）。
糖尿病与慢性肾脏病患者，主要是那些不需要肾脏替代治疗的患者的较高死亡风险相关。
