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新型冠状病毒感染对未接受肾脏替代治疗的慢性肾脏病患者肾功能的长期影响

Impact of Coronavirus Disease 2019 on long-term renal function in patients with chronic kidney disease undergoing no renal replacement therapy

    摘要
  • 摘要:
    目的 探讨新型冠状病毒感染(COVID-19)对未接受肾脏替代治疗的慢性肾脏病(CKD)患者肾功能的长期影响。
    方法 选取贵州航天医院2022年12月—2023年3月收治的确诊COVID-19时估算肾小球滤过率(eGFR) < 60 mL/(min·1.73 m2)的39例CKD患者纳入COVID-19组, 另选取2021年9—12月收治的未患COVID-19的40例CKD患者纳入对照组。比较2组患者的eGFR变化情况，基于混合线性模型分析COVID-19组eGFR水平随时间的变化。
    结果 COVID-19组患者的基线eGFR水平和随访1、3个月时的eGFR水平与对照组比较，差异均无统计学意义(P>0.05); 随访1年时, COVID-19组患者的eGFR水平低于对照组，差异有统计学意义(P < 0.05)。混合线性模型分析结果显示, COVID-19组患者发生COVID-19后1年内eGFR水平下降1.84 mL/(min·1.73 m2), 相当于较基线水平下降4.62%, 其中糖尿病患者的eGFR水平下降幅度最大(7.45%)。
    结论 未接受肾脏替代治疗的CKD患者发生COVID-19后1年内eGFR大幅下降，肾功能恶化加剧，应接受密切的长期肾功能监测和及时干预。

     

    Abstract:
    Objective To investigate the impact of Coronavirus Disease 2019 (COVID-19) on long-term renal function in patients with chronic kidney disease (CKD) who received no renal replacement therapy.
    Methods Thirty-nine CKD patients with an estimated glomerular filtration rate (eGFR) < 60 mL/(min·1.73 m2) at the time of COVID-19 diagnosis, admitted to Guizhou Aerospace Hospital from December 2022 to March 2023, were enrolled in the COVID-19 group. Additionally, 40 CKD patients without COVID-19 from September to December 2021, were included in control group. Changes in eGFR were compared between the two groups, and the temporal trend of eGFR in the COVID-19 group was analyzed using a mixed-effects linear model.
    Results No statistically significant differences were observed in eGFR levels at baseline, 1- and 3-month of follow-up between the COVID-19 and control groups (P>0.05). However, at 1 year of follow-up, the eGFR level in the COVID-19 group was significantly lower than that in the control group (P < 0.05). The mixed-effects linear model analysis revealed a decrease in eGFR by 1.84 mL/(min·1.73 m2) within 1 year of COVID-19 onset in the COVID-19 group, which inclined 4.62% from baseline, with the most significant decline (7.45%) observed among diabetic patients.
    Conclusion Patients with CKD who have not undergone renal replacement therapy experience a substantial decline in eGFR and worsened renal function within 1 year of COVID-19, necessitating close long-term renal function monitoring and timely interventions.

     

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