龚文姜, 蔡明玉, 万静芳, 傅丽丽, 侯世会, 杨杰. 尿毒症维持性透析患者合并新型冠状病毒感染预后的危险因素分析[J]. 临床肾脏病杂志, 2024, 24(6): 441-445. DOI: 10.3969/j.issn.1671-2390.2024.06.001
    引用本文: 龚文姜, 蔡明玉, 万静芳, 傅丽丽, 侯世会, 杨杰. 尿毒症维持性透析患者合并新型冠状病毒感染预后的危险因素分析[J]. 临床肾脏病杂志, 2024, 24(6): 441-445. DOI: 10.3969/j.issn.1671-2390.2024.06.001
    Gong Wen-jiang, Cai Ming-yu, Wan Jing-fang, Fu Li-li, Hou Shi-hui, Yang Jie. Risk factors for prognoses of uremic maintenance dialysis patients with novel coronavirus infection[J]. Journal of Clinical Nephrology, 2024, 24(6): 441-445. DOI: 10.3969/j.issn.1671-2390.2024.06.001
    Citation: Gong Wen-jiang, Cai Ming-yu, Wan Jing-fang, Fu Li-li, Hou Shi-hui, Yang Jie. Risk factors for prognoses of uremic maintenance dialysis patients with novel coronavirus infection[J]. Journal of Clinical Nephrology, 2024, 24(6): 441-445. DOI: 10.3969/j.issn.1671-2390.2024.06.001

    尿毒症维持性透析患者合并新型冠状病毒感染预后的危险因素分析

    Risk factors for prognoses of uremic maintenance dialysis patients with novel coronavirus infection

    • 摘要:
      目的  回顾性分析尿毒症维持性透析患者合并新型冠状病毒感染预后的危险因素。
      方法  选择陆军特色医学中心规律随访的维持性透析患者,收集新型冠状病毒感染前的基线临床及实验室资料。Logistic 回归方法分析全因死亡及重症新型冠状病毒肺炎的危险因素。
      结果  556例患者中男性312例,女性244例,年龄(52.37 ± 14.81)岁,透析龄(61.02 ± 43.90)个月,原发病为糖尿病肾脏疾病101例(18.1%)。合并症前3位的为糖尿病135例(16.3%),心血管病史48例(6.6%),脑卒中史3例(0.5%)。血液透析192例(34.5%),腹膜透析364例(65.5%)。原发病为糖尿病肾脏疾病,合并症有糖尿病、血液透析、年龄、血钠水平是患者感染新型冠状病毒后死亡的危险因素,血清前白蛋白水平是保护性因素,多因素回归分析显示血液透析、年龄是死亡的独立危险因素。合并症有心血管疾病、血液透析、年龄、高血糖是患者感染新型冠状病毒后发生重症肺炎的危险因素,血清白蛋白水平是保护性因素。合并症有心血管疾病、年龄、高血糖是发生重症肺炎的独立危险因素。
      结论  心血管疾病和高血糖是发生重症肺炎的独立危险因素,年龄是发生重症肺炎和死亡的独立危险因素,血液透析患者较腹膜透析患者有更高的死亡风险。

       

      Abstract:
      Objective  To retrospectively explore the prognostic factors of uremic maintenance hemodialysis (MHD) patients with novel COVID-19 infection.
      Methods  A total of 556 MHD patients on regular follow-ups were recruited. Baseline profiles and laboratory tests were recorded prior to contracting COVID-19 infection.
      Results  There were 312 males and 244 females with an age of (52.37 ± 14.81) year and an MHD duration of (61.02 ± 43.90) months. Diabetic kidney disease(DKD) was a primary disease (n = 101, 18.1%) with top three complications of diabetes mellitus (DM)(n = 135, 16.3%), cardiovascular disease (CVD)(n = 48, 6.6%) and stroke (n = 3, 0.5%). Hemodialysis (n = 192, 34.5%) and peritoneal dialysis (PD)(n = 364, 65.5%) were performed. DM, hemodialysis, age and serum sodium level were risk factors for mortality after COVID-19 infection. And serum prealbumin level was a protective factor. Multivariate regression analysis revealed that MHD and age were independent risk factors for mortality. Cardiovascular disease, MHD, age and blood glucose level were risk factors for severe pneumonia after COVID-19 infection. And serum albumin level was a protective factor.
      Conclusion  CVD and hyperglycemia are independent risk factors for severe pneumonia while age is an independent risk factor for severe pneumonia and mortality. Generally MHD patients have a higher risk of mortality than PD counterparts.

       

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