Clin Nephrol. 2024 Oct;102(4):187-191. doi: 10.5414/CN111323.
The mortality rate for -COVID-19 infection varies significantly depending on age and comorbidities but remains high in hospitalized patients overall. Several retrospective studies have identified patients with end-stage kidney disease (ESKD) to be at increased risk. The objective of this study was to study in-hospital outcomes of ESKD patients at an academic medical center and identify characteristics that place them at a higher risk for in-hospital mortality.
A retrospective chart review was conducted including adult patients (≥ 18 years old) admitted to Loma Linda Medical Center for COVID-19 infection with a previous diagnosis of ESKD. Patients with prior kidney transplants were excluded. The main outcome of this study was the rate of in-hospital mortality.
21 of the 91 patients died with a mortality rate of 23%. Age, D-dimer > 0.4 µg/mL, ejection fraction less than 50%, and ferritin > 300 ng/mL were predictors for mortality in unadjusted univariate analysis. Adjusted multivariable analysis demonstrated that only an ejection fraction of less than 50% was associated with increased mortality risk.
Cardiovascular disease is the leading cause of mortality for ESKD patients and also places them at increased risk of mortality in the setting of severe COVID-19 infection.
COVID-19 感染的死亡率因年龄和合并症而异，但住院患者的总体死亡率仍然很高。几项回顾性研究表明，终末期肾病（ESKD）患者的风险增加。本研究的目的是研究学术医疗中心的 ESKD 患者的住院期间结局，并确定使他们面临更高住院死亡率风险的特征。
进行了回顾性图表审查，包括因 COVID-19 感染而在洛马林达医疗中心住院的患有先前诊断的 ESKD 的成年患者（≥18 岁）。排除了先前有肾脏移植的患者。本研究的主要结局是住院死亡率。
91 名患者中有 21 名死亡，死亡率为 23%。在未调整的单因素分析中，年龄、D-二聚体>0.4μg/mL、射血分数<50%和铁蛋白>300ng/mL 是死亡的预测因素。调整后的多变量分析表明，只有射血分数<50%与增加的死亡风险相关。
心血管疾病是 ESKD 患者死亡的主要原因，并且在严重 COVID-19 感染的情况下也使他们面临更高的死亡风险。
