PDF(Pubmed)
Abstract：
UNASSIGNED: The Covid-19 pandemic has affected patients with end-stage kidney disease (ESKD). Whether dialysis parameters have a prognostic value in ESKD patients with Covid-19 remains unclear.
UNASSIGNED: We retrospectively evaluated clinical characteristics, blood pressure (BP) and dialysis parameters in ESKD patients undergoing maintenance outpatient hemodialysis, with (Covid-ESKD) and without (No-Covid-ESKD) Covid-19, at four Brazilian hemodialysis facilities. The Covid-ESKD (n = 107; 54% females; 60.8 ± 17.7 years) and No-Covid-ESKD (n = 107; 62% females; 58.4 ± 14.6 years) groups were matched by calendar time. The average BP and dialysis parameters were calculated during the pre-infection, acute infection, and post-infection periods. The main outcomes were Covid-19 hospitalization and all-cause mortality.
UNASSIGNED: Covid-ESKD patients had greater intradialytic and postdialysis systolic BP and lower predialysis weight, postdialysis weight, ultrafiltration rate, and interdialytic weight gain during acute-illness compared to 1-week-before-illness, while these changes were not observed in No-Covid-ESKD patients. After 286 days of follow-up (range, 276-591), there were 18 Covid-19-related hospitalizations and 28 deaths among Covid-ESKD patients. Multivariable logistic regression analysis showed that increases in predialysis systolic BP from 1-week-before-illness to acute-illness (OR, 95%CI = 1.06, 1.02-1.10; p = .004) and Covid-19 vaccination (OR, 95%CI = 0.16, 0.04-0.69; p = .014) were associated with hospitalization in Covid-ESKD patients. Multivariable Cox-regression analysis showed that Covid-19-related hospitalization (HR, 95%CI = 5.17, 2.07-12.96; p < .001) and age (HR, 95%CI = 1.05, 1.01-1.08; p = .008) were independent predictors of all-cause mortality in Covid-ESKD patients.
UNASSIGNED: Acute Covid-19 illness is associated with variations in dialysis parameters of volume status in patients with ESKD. Furthermore, increases in predialysis BP during acute Covid-19 illness are associated with an adverse prognosis in Covid-ESKD patients.
Dialysis parameters were influenced by SARS-CoV-2 infection and may have prognostic value in patients with Covid-19.Increases in blood pressure during acute Covid-19 illness and the lack of vaccination for Covid-19 were predictors of hospitalization for Covid-19.Hospitalization for Covid-19 and age were independent risk factors for all-cause death.
UNASSIGNED: We retrospectively evaluated clinical characteristics, blood pressure (BP) and dialysis parameters in ESKD patients undergoing maintenance outpatient hemodialysis, with (Covid-ESKD) and without (No-Covid-ESKD) Covid-19, at four Brazilian hemodialysis facilities. The Covid-ESKD (n = 107; 54% females; 60.8 ± 17.7 years) and No-Covid-ESKD (n = 107; 62% females; 58.4 ± 14.6 years) groups were matched by calendar time. The average BP and dialysis parameters were calculated during the pre-infection, acute infection, and post-infection periods. The main outcomes were Covid-19 hospitalization and all-cause mortality.
UNASSIGNED: Covid-ESKD patients had greater intradialytic and postdialysis systolic BP and lower predialysis weight, postdialysis weight, ultrafiltration rate, and interdialytic weight gain during acute-illness compared to 1-week-before-illness, while these changes were not observed in No-Covid-ESKD patients. After 286 days of follow-up (range, 276-591), there were 18 Covid-19-related hospitalizations and 28 deaths among Covid-ESKD patients. Multivariable logistic regression analysis showed that increases in predialysis systolic BP from 1-week-before-illness to acute-illness (OR, 95%CI = 1.06, 1.02-1.10; p = .004) and Covid-19 vaccination (OR, 95%CI = 0.16, 0.04-0.69; p = .014) were associated with hospitalization in Covid-ESKD patients. Multivariable Cox-regression analysis showed that Covid-19-related hospitalization (HR, 95%CI = 5.17, 2.07-12.96; p < .001) and age (HR, 95%CI = 1.05, 1.01-1.08; p = .008) were independent predictors of all-cause mortality in Covid-ESKD patients.
UNASSIGNED: Acute Covid-19 illness is associated with variations in dialysis parameters of volume status in patients with ESKD. Furthermore, increases in predialysis BP during acute Covid-19 illness are associated with an adverse prognosis in Covid-ESKD patients.
Dialysis parameters were influenced by SARS-CoV-2 infection and may have prognostic value in patients with Covid-19.Increases in blood pressure during acute Covid-19 illness and the lack of vaccination for Covid-19 were predictors of hospitalization for Covid-19.Hospitalization for Covid-19 and age were independent risk factors for all-cause death.
摘要：
■新冠肺炎大流行影响了终末期肾病(ESKD)患者。透析参数在ESKD合并Covid-19患者中是否具有预后价值尚不清楚。
■我们回顾性评估了临床特征，接受维持性门诊血液透析的ESKD患者的血压（BP）和透析参数，在巴西的四家血液透析设施中，有(Covid-ESKD)和没有(No-Covid-ESKD)Covid-19。Covid-ESKD(n=107；54%女性；60.8±17.7岁)和No-Covid-ESKD(n=107；62%女性；58.4±14.6岁)组按日历时间进行匹配。在感染前计算平均BP和透析参数，急性感染,和感染后时期。主要结果是新冠肺炎住院和全因死亡率。
■Covid-ESKD患者透析中和透析后收缩压较高，透析前体重较低，透析后体重,超滤率,与患病前1周相比，急性疾病期间的透析间体重增加，而在非Covid-ESKD患者中未观察到这些变化。经过286天的随访（范围，276-591),Covid-ESKD患者中有18例与Covid-19相关的住院治疗和28例死亡。多变量logistic回归分析显示，从发病前1周到急性疾病，透析前收缩压升高（OR，95CI=1.06，1.02-1.10；p=.004)和新冠肺炎疫苗接种(OR，95CI=0.16，0.04-0.69；p=0.014）与Covid-ESKD患者的住院相关。多变量Cox回归分析显示，Covid-19相关住院(HR，95CI=5.17，2.07-12.96；p<.001）和年龄（HR，95CI=1.05，1.01-1.08；p=.008）是Covid-ESKD患者全因死亡率的独立预测因子。
急性Covid-19疾病与ESKD患者容量状态的透析参数变化有关。此外，急性Covid-19疾病期间透析前血压升高与Covid-ESKD患者的不良预后相关。
透析参数受SARS-CoV-2感染的影响，可能对Covid-19患者具有预后价值。急性新冠肺炎疾病期间血压的升高和缺乏新冠肺炎疫苗接种是新冠肺炎住院的预测因素。新冠肺炎住院和年龄是全因死亡的独立危险因素。
■我们回顾性评估了临床特征，接受维持性门诊血液透析的ESKD患者的血压（BP）和透析参数，在巴西的四家血液透析设施中，有(Covid-ESKD)和没有(No-Covid-ESKD)Covid-19。Covid-ESKD(n=107；54%女性；60.8±17.7岁)和No-Covid-ESKD(n=107；62%女性；58.4±14.6岁)组按日历时间进行匹配。在感染前计算平均BP和透析参数，急性感染,和感染后时期。主要结果是新冠肺炎住院和全因死亡率。
■Covid-ESKD患者透析中和透析后收缩压较高，透析前体重较低，透析后体重,超滤率,与患病前1周相比，急性疾病期间的透析间体重增加，而在非Covid-ESKD患者中未观察到这些变化。经过286天的随访（范围，276-591),Covid-ESKD患者中有18例与Covid-19相关的住院治疗和28例死亡。多变量logistic回归分析显示，从发病前1周到急性疾病，透析前收缩压升高（OR，95CI=1.06，1.02-1.10；p=.004)和新冠肺炎疫苗接种(OR，95CI=0.16，0.04-0.69；p=0.014）与Covid-ESKD患者的住院相关。多变量Cox回归分析显示，Covid-19相关住院(HR，95CI=5.17，2.07-12.96；p<.001）和年龄（HR，95CI=1.05，1.01-1.08；p=.008）是Covid-ESKD患者全因死亡率的独立预测因子。
急性Covid-19疾病与ESKD患者容量状态的透析参数变化有关。此外，急性Covid-19疾病期间透析前血压升高与Covid-ESKD患者的不良预后相关。
透析参数受SARS-CoV-2感染的影响，可能对Covid-19患者具有预后价值。急性新冠肺炎疾病期间血压的升高和缺乏新冠肺炎疫苗接种是新冠肺炎住院的预测因素。新冠肺炎住院和年龄是全因死亡的独立危险因素。
