{"id":25584,"date":"2024-04-19T04:22:00","date_gmt":"2024-04-18T20:22:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25584"},"modified":"2024-04-19T06:29:28","modified_gmt":"2024-04-18T22:29:28","slug":"jama-intern-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%96%b0%e5%86%a0%e7%97%85%e6%af%92%e6%84%9f%e6%9f%93%e7%9b%b8%e5%85%b3%e6%80%a5%e6%80%a7%e8%82%be%e6%8d%9f%e4%bc%a4%e4%bb%a5%e5%8f%8a","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25584","title":{"rendered":"[JAMA Intern Med\u53d1\u8868\u8bba\u6587]\uff1a\u65b0\u51a0\u75c5\u6bd2\u611f\u67d3\u76f8\u5173\u6025\u6027\u80be\u635f\u4f24\u4ee5\u53ca\u80be\u810f\u957f\u671f\u9884\u540e"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

February 26, 2024<\/p>\n\n\n\n

COVID-19\u2212Associated Acute Kidney Injury and Longitudinal Kidney Outcomes<\/h1>\n\n\n\n

Abinet M.\u00a0Aklilu,\u00a0Sanchit\u00a0Kumar,\u00a0James\u00a0Nugent,\u00a0et al<\/h3>\n\n\n\n

JAMA Intern Med.\u00a0<\/em>Published online February 26, 2024. doi:10.1001\/jamainternmed.2023.8225<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Are hospitalized patients who develop acute kidney injury (AKI) associated with COVID-19 at risk of worse kidney function trajectory and higher mortality than those with AKI associated with other illnesses?<\/p>\n\n\n\n

Findings<\/strong>  This multicenter cohort study using electronic health records of 9624 hospitalized patients with AKI found that patients with COVID-19\u2212associated AKI had a 33% lower risk of major adverse kidney events with 22% lower risk of worsened kidney function and 69% lower risk of mortality compared with those with AKI due to other illnesses.<\/p>\n\n\n\n

Meaning<\/strong>  These findings indicate that survivors of hospitalization with COVID-19\u2212associated AKI have a significantly lower risk of long-term kidney function decline and all-cause mortality than those with AKI associated with other illnesses.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  COVID-19 infection is associated with a high incidence of acute kidney injury (AKI). Although rapid kidney function decline has been reported in the first few months after COVID-19\u2212associated AKI (COVID-AKI), the longer-term association of COVID-AKI with kidney function remains unknown.<\/p>\n\n\n\n

Objective<\/strong>  To assess long-term kidney outcomes of patients who had COVID-19\u2212associated AKI.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This was a retrospective longitudinal multicenter cohort study conducted in a large hospital system using electronic health records data on adult hospitalized patients with AKI and COVID-19 or other illnesses. Included patients were hospitalized during the COVID-19 pandemic (March 2020-June 2022), were screened for SARS-CoV-2, had AKI, and survived to discharge, or had been hospitalized during the 5 years before the pandemic (October 2016-January 2020), had a positive influenza A or B test result, had AKI, and survived to discharge. Patients were followed up for a maximum of 2 years after hospital discharge. Data analyses were performed from December 2022 to November 2023.<\/p>\n\n\n\n

Exposure<\/strong>  COVID-19 and influenza.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was major adverse kidney events (MAKE), defined as a composite of mortality and worsened kidney function (estimated glomerular filtration rate [eGFR] decline by \u226525% from discharge eGFR or kidney failure requiring dialysis). Multivariable time-to-event analyses were performed to compare MAKE between individuals with COVID-AKI and those who had AKI associated with other illnesses hospitalized during the same period. For further comparison, this outcome was assessed for a historic cohort of patients with influenza-associated AKI.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0The study cohort included 9624 hospitalized patients (mean [SD] age, 69.0 [15.7] years; 4955 [51.5%] females) with AKI, including 987 patients with COVID-AKI, 276 with influenza-associated AKI, and 8361 with AKI associated with other illnesses (other-AKI). Compared with the other 2 groups, patients with COVID-19\u2212associated AKI were slightly younger in age, had a higher baseline eGFR, worse baseline comorbidity scores, higher markers of illness severity, and longer hospital stay. Compared with the other-AKI group, the COVID-AKI group had lower MAKE (adjusted hazard ratio [aHR], 0.67; 95% CI, 0.59-0.75) due to lower all-cause mortality (aHR, 0.31; 95% CI, 0.24-0.39) and lower rates of worsened kidney function (aHR, 0.78; 95% CI, 0.69-0.88).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions and Relevance<\/strong>  The findings of this multicenter cohort study indicate that survivors of hospitalization with COVID-AKI experience lower rates of MAKE, long-term kidney function decline, and mortality compared with patients with AKI associated with other illnesses.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  February 26, 202 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25584"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25584"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25584\/revisions"}],"predecessor-version":[{"id":25585,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25584\/revisions\/25585"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25584"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25584"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25584"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}