The incidence, risk factors and prognosis of acute kidney injury in severe and critically ill patients with COVID-19 in mainland China: a retrospective study

BMC Pulmonary Medicine

Xia Zheng¹  Wenjuan Wu²  Li Jiang³  Chun Pan⁴  Ming Zhong⁵  Shiyue Li⁶  Sibei Chen⁶  Zhihui Zhang⁶  Xuesong Liu⁶  Yonghao Xu⁶  Weijie Guan⁶  Ling Sang⁶  Yimin Li⁶  Nanshan Zhong⁶  Xiaoqing Liu⁶  Nanshan Chen⁷  Wenhua Liang⁸  Jianxing He⁸  Jiaan Xia⁹  Wei Zhang^1,10  Dingyu Zhang^1,11  Hongkai Wu^1,12 

[1] Department of Critical Care Medicine, The First Affiliated Hospital of Zhejiang University, Zhejiang, Hangzhou, China;Department of Critical Care Medicine, Wuhan Jinyintan Hospital, Wuhan, China;Department of Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China;Department of Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing, China;Department of Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China;Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China;Department of Respiratory and Critical Care Medicine, Wuhan Jinyintan Hospital, Wuhan, China;Department of Thorax Surgery, State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China;Department of tuberculosis, Wuhan Jinyintan Hospital, Wuhan, China;Emergency Department, the 900th Hospital of Joint Service Corps of Chinese PLA, FuZhou, China;Research Center for Translational Medicine, Wuhan Jinyintan Hospital, Wuhan, China;Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, China;State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China;

关键词: Coronavirus disease 2019;    Acute respiratory distres;    Syndrome;    Acute kidney injury;    Intensive care unit;    Mechanical ventilation;   

DOI  :  10.1186/s12890-020-01305-5

来源: Springer

【 摘 要 】

BackgroundThe clinical correlates, prognosis and determinants of acute kidney injury (AKI) in patients with coronavirus disease 2019 (Covid-19) remain largely unclear.MethodsWe retrospectively reviewed medical records of all adult patients with laboratory-confirmed Covid-19 who were admitted to the intensive care unit (ICU) between January 23rd 2020 and April 6th 2020 at Wuhan JinYinTan Hospital and The First Affiliated Hospital of Guangzhou Medical University.ResultsAmong 210 patients, 131 were males (62.4%). The median Age was 64 years (IQR: 56–71). Of 92 (43.8%) patients who developed AKI during hospitalization, 13 (14.1%), 15 (16.3%) and 64 (69.6%) were classified as being at stage 1, 2 and 3, respectively. 54 patients (58.7%) received continuous renal replacement therapy. Age, sepsis, nephrotoxic drug, invasive mechanical ventilation and elevated baseline serum creatinine levels were associated with the occurrence of AKI. Renal recovery during hospitalization was identified among 16 patients with AKI (17.4%), who had a significantly shorter time from admission to AKI diagnosis, lower incidence of right heart failure and higher ratio of partial pressure of oxygen to the fraction of inspired oxygen. Of 210 patients, 93 deceased within 28 days of ICU admission. AKI stage 3, critical disease, greater Age and the lowest ratio of partial pressure of oxygen to the fraction of inspired oxygen being < 150 mmHg were independently associated with death.ConclusionsAmong patients with Covid-19, the incidence of AKI was high. Our findings of the risk factors of the development of AKI and factors associated with renal function recovery may inform clinical management of patients with critical illness of Covid-19.

【 授权许可】

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