Prevalence of Kidney Injury and Associations with Critical Illness and Death in Patients with COVID-19

作者：Xizi Zheng, Hongyu Yang, Xiaolong Li, Haichao Li, Lingyi Xu, Yu Qi, Yaping Dong, Youlu Zhao, Jinwei Wang, Wanyin Hou, Xin Zhang, Yang Li, Feng Hu, Hong Gao, Jicheng Lv, Yang Li · 发表于：Clinical Journal of the American Society of Nephrology · 年份：2020 · DOI：10.2215/cjn.04780420 · 被引用次数：66 · 研究领域：COVID-19 Clinical Research Studies、COVID-19 Impact on Reproduction、Acute Kidney Injury Research

BACKGROUND AND OBJECTIVES: Coronavirus disease 2019 is spreading rapidly across the world. This study aimed to assess the characteristics of kidney injury and its association with disease progression and death of patients with coronavirus disease 2019. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a retrospective study. Two representative cohorts were included. Cohort 1 involved severe and critical patients with coronavirus disease 2019 from Wuhan, China. Cohort 2 was all patients with coronavirus disease 2019 in Shenzhen city (Guangdong province, China). Any kidney injury was defined as the presence of any of the following: hematuria, proteinuria, in-hospital AKI, or prehospital AKI. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) creatinine criteria. The primary outcome was death at the end of follow-up. The secondary outcome was progression to critical illness during the study period. RESULTS: A total of 555 patients were enrolled; 42% of the cases (229 of 549) were detected with any kidney injury, 33% of the cases (174 of 520) were detected with proteinuria, 22% of the cases (112 of 520) were detected with hematuria, and 6% of the cases (29 of 520) were detected with AKI. Of the 29 patients with AKI, 21 cases were recognized as in-hospital AKI, and eight were recognized as prehospital AKI. Altogether, 27 (5%) patients died at the end of follow-up. The death rate was 11% (20 of 174) in patients with proteinuria, 16% (18 of 112) in...