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需要肾脏替代治疗的新型冠状病毒肺炎急性肾损伤患者的长期预后

Long-term outcome of COVID-19 patients with acute kidney injury requiring kidney replacement therapy.

作者信息

Godi Ilaria, Pasin Laura, Ballin Andrea, Martelli Gabriele, Bonanno Claudio, Terranova Francesco, Tamburini Enrico, Simoni Caterina, Randon Ginevra, Franchetti Nicola, Cattarin Leda, Nalesso Federico, Calò Lorenzo, Tiberio Ivo

机构信息

Department of Urgency and Emergency, Anaesthesiology and Intensive Care Unit, University Hospital of Padua, Via Giustiniani 2, Padua, Italy.

Department of Medicine, Section of Anesthesiology and Critical Care, University of Padua, Padua, Italy.

出版信息

J Anesth Analg Crit Care. 2024 May 9;4(1):32. doi: 10.1186/s44158-024-00163-5.

Abstract

BACKGROUND

Limited data existed on the burden of coronavirus disease 2019 (COVID-19) renal complications and the outcomes of the most critical patients who required kidney replacement therapy (KRT) during intensive care unit (ICU) stay. We aimed to describe mortality and renal function at 90 days in patients admitted for COVID-19 and KRT.

METHODS

A retrospective cohort study of critically ill patients admitted for COVID-19 and requiring KRT from March 2020 to January 2022 was conducted in an Italian ICU from a tertiary care hospital. Primary outcome was mortality at 90 days and secondary outcome was kidney function at 90 days.

RESULTS

A cohort of 45 patients was analyzed. Mortality was 60% during ICU stay and increased from 64% at the time of hospital discharge to 71% at 90 days. Among 90-day survivors, 31% required dialysis, 38% recovered incompletely, and 31% completely recovered renal function. The probability of being alive and dialysis-free at 3 months was 22%.

CONCLUSIONS

Critically ill patients with COVID-19 disease requiring KRT during ICU stay had elevated mortality rate at 90 days, with low probability of being alive and dialysis-free at 3 months. However, a non-negligible number of patients completely recovered renal function.

摘要

背景

关于2019冠状病毒病(COVID-19)肾脏并发症的负担以及在重症监护病房(ICU)住院期间需要肾脏替代治疗(KRT)的最危重患者的预后,现有数据有限。我们旨在描述因COVID-19和KRT入院患者90天时的死亡率和肾功能。

方法

对2020年3月至2022年1月在一家三级护理医院的意大利ICU中因COVID-19入院并需要KRT的重症患者进行了一项回顾性队列研究。主要结局是90天时的死亡率,次要结局是90天时的肾功能。

结果

分析了45例患者的队列。ICU住院期间的死亡率为60%,从出院时的64%增加到90天时的71%。在9组幸存者中,31%需要透析,38%恢复不完全,31%肾功能完全恢复。3个月时存活且无需透析的概率为2组。

结论

在ICU住院期间因COVID-19疾病需要KRT的重症患者在90天时死亡率升高,3个月时存活且无需透析的概率较低。然而,有相当数量的患者肾功能完全恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bd9/11083751/68c8807405a1/44158_2024_163_Fig1_HTML.jpg

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