Nephrology Unit, Kr 7 40 62 Hospital Universitario San Ignacio, 110231, Bogotá, DC, Colombia.
Department of Internal Medicine, School of Medicine, Pontificia Universidad Javeriana, Bogotá, DC, Colombia.
BMC Nephrol. 2023 May 22;24(1):140. doi: 10.1186/s12882-023-03172-8.
Patients with COVID-19 have a high incidence of acute kidney injury (AKI), which is associated with mortality. The objective of the study was to determine the factors associated with AKI in patients with COVID-19.
A retrospective cohort was established in two university hospitals in Bogotá, Colombia. Adults hospitalized for more than 48 h from March 6, 2020, to March 31, 2021, with confirmed COVID-19 were included. The main outcome was to determine the factors associated with AKI in patients with COVID-19 and the secondary outcome was estimate the incidence of AKI during the 28 days following hospital admission.
A total of 1584 patients were included: 60.4% were men, 738 (46.5%) developed AKI, 23.6% were classified as KDIGO 3, and 11.1% had renal replacement therapy. The risk factors for developing AKI during hospitalization were male sex (OR 2.28, 95% CI 1.73-2.99), age (OR 1.02, 95% CI 1.01-1.03), history of chronic kidney disease (CKD) (OR 3.61, 95% CI 2.03-6.42), High Blood Pressure (HBP) (OR 6.51, 95% CI 2.10-20.2), higher qSOFA score to the admission (OR 1.4, 95% CI 1.14-1.71), the use of vancomycin (OR 1.57, 95% CI 1.05-2.37), piperacillin/tazobactam (OR 1.67, 95% CI 1.2-2.31), and vasopressor support (CI 2.39, 95% CI 1.53-3.74). The gross hospital mortality for AKI was 45.5% versus 11.7% without AKI.
This cohort showed that male sex, age, history of HBP and CKD, presentation with elevated qSOFA, in-hospital use of nephrotoxic drugs and the requirement for vasopressor support were the main risk factors for developing AKI in patients hospitalized for COVID-19.
COVID-19 患者急性肾损伤（AKI）的发生率很高，与死亡率相关。本研究的目的是确定 COVID-19 患者 AKI 的相关因素。
在哥伦比亚波哥大的两家大学医院建立了回顾性队列。纳入 2020 年 3 月 6 日至 2021 年 3 月 31 日住院时间超过 48 小时且确诊 COVID-19 的成年患者。主要结局是确定 COVID-19 患者 AKI 的相关因素，次要结局是估计住院后 28 天内 AKI 的发生率。
共纳入 1584 例患者：60.4%为男性，738 例（46.5%）发生 AKI，73.8%为 KDIGO 3 期，11.1%接受肾脏替代治疗。住院期间发生 AKI 的危险因素包括男性（OR 2.28，95%CI 1.73-2.99）、年龄（OR 1.02，95%CI 1.01-1.03）、慢性肾脏病（CKD）史（OR 3.61，95%CI 2.03-6.42）、高血压（HBP）（OR 6.51，95%CI 2.10-20.2）、较高的 qSOFA 评分（OR 1.4，95%CI 1.14-1.71）、万古霉素的使用（OR 1.57，95%CI 1.05-2.37）、哌拉西林/他唑巴坦（OR 1.67，95%CI 1.2-2.31）和血管加压素支持（CI 2.39，95%CI 1.53-3.74）。AKI 的总住院死亡率为 45.5%，无 AKI 者为 11.7%。
本队列显示，男性、年龄、HBP 和 CKD 史、qSOFA 升高、住院期间使用肾毒性药物和血管加压素支持是 COVID-19 住院患者发生 AKI 的主要危险因素。
