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住院的 COVID-19 患者中的急性肾损伤:一项回顾性观察研究。

Acute Kidney Injury In Hospitalized Covid-19 Patients: A Retrospective Observational Study.

机构信息

Department of Medicine, Northwest General Hospital and Research Center, Peshawar.

Department of Nephrology, Peshawar Medical College, Peshawar.

出版信息

J Ayub Med Coll Abbottabad. 2022 Jul-Sep;34(Suppl 1)(3):S665-S670. doi: 10.55519/JAMC-03-S1-9734.

Abstract

BACKGROUND

Published studies have reported that acute kidney injury (AKI) and other kidney related manifestations are associated with COVID-19 and linked with poor outcome. This study aimed to determine the incidence, risk factors and outcomes of AKI in hospitalized COVID-19 patients.

METHODS

This retrospective study of 154 patients involved retrieving data from hospital records confirm COVID-19 infection admitted to the Northwest General Hospital & Research Center, Peshawar from 1st April to 31st July 2020. AKI was defined using kidney disease. Improving Global Outcomes (KDIGO)" guidelines.

RESULTS

Incidence of AKI was 37.01%. Age, gender, intensive care (ICU) requirement, number of comorbid, diabetes mellitus, coronary artery disease, chronic kidney disease, chronic obstructive airway disease (COAD), arrhythmias among comorbid and fever and shortness of breath among symptoms were found to be significantly differed between AKI and non-AKI patients. Numerous differences of laboratory results such as serum sodium, potassium, total leukocyte count, absolute lymphocyte count and platelets between both groups were observed (p<0.05). Inflammatory markers including lactate dehydrogenase (LDH), ferritin, d-dimer and C-reactive protein (CRP) were significantly raised in AKI group. Overall mortality was observed to be 38 (24.7%). Moreover, age, ICU requirement; COAD, creatinine, serum sodium, inflammatory markers (LDH, ferritin, d-dimers and CRP), total leukocyte count, absolute lymphocyte count, platelets and support requirement were significantly differed between survivors and non-survivors. Mortality was significantly higher among AKI group, i.e., 52.6% compared to 8.2% in non-AKI group (p<0.001).

CONCLUSION

AKI is common among hospitalized COVID-19 patients and is associated with mortality. In all, AKI patients less than half of the patients survived.

摘要

背景

已发表的研究报告表明,急性肾损伤(AKI)和其他肾脏相关表现与 COVID-19 相关,并与不良预后相关。本研究旨在确定住院 COVID-19 患者中 AKI 的发生率、危险因素和结局。

方法

这项回顾性研究纳入了 154 名患者,从 2020 年 4 月 1 日至 7 月 31 日期间在西北总医院和研究中心(巴基斯坦白沙瓦)住院的经医院记录证实的 COVID-19 感染患者中提取数据。AKI 采用肾脏病。改善全球结局(KDIGO)“指南定义。

结果

AKI 的发生率为 37.01%。年龄、性别、重症监护(ICU)需求、合并症数量、糖尿病、冠心病、慢性肾脏病、慢性阻塞性气道疾病(COAD)、合并症中的心律失常以及症状中的发热和呼吸急促在 AKI 和非 AKI 患者之间存在显著差异。两组间的实验室结果如血清钠、钾、总白细胞计数、绝对淋巴细胞计数和血小板等存在许多差异(p<0.05)。炎症标志物包括乳酸脱氢酶(LDH)、铁蛋白、D-二聚体和 C 反应蛋白(CRP)在 AKI 组中显著升高。观察到总体死亡率为 38(24.7%)。此外,年龄、ICU 需求、COAD、肌酐、血清钠、炎症标志物(LDH、铁蛋白、D-二聚体和 CRP)、总白细胞计数、绝对淋巴细胞计数、血小板和支持需求在幸存者和非幸存者之间存在显著差异。AKI 组的死亡率明显更高,即 52.6%,而非 AKI 组为 8.2%(p<0.001)。

结论

AKI 在住院 COVID-19 患者中很常见,与死亡率相关。总之,AKI 患者中只有不到一半的患者存活。

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