Ntu 1: Kev Sib Piv Ntawm Tus Kab Mob Khaus Viv ({1}} Tus Kab Mob Cuam Tshuam Ntawm Qhov tshwm sim, nta, thiab rov qab los ntawm mob raum raug mob hauv tsev kho mob hauv Tebchaws Meskas cov qub tub rog

Bethany C.Birkelol, et al

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Mob hnyavraum raug mobyog ib qho teeb meem tshwm sim hauv cov neeg mob hauv tsev kho mob nrog SARS-CoV-2 (COVID-19), nrog rau cov kev tshawb fawb ua ntej cuam tshuam txog ntau yam kev raug mob. Txawm hais tias COVID-19 feem ntau piv rau lwm yam kab mob ua pa, ob peb qhov kev sib piv ntawm cov kab mob no ntawmraumnoj qab haus huvmuaj. Hauv qhov kev tshawb fawb rov qab no, peb muab piv rau qhov xwm txheej, yam ntxwv, thiab qhov tshwm sim ntawm qhov mob hnyavraum raug mobntawm cov qub tub rog nyob hauv tsev kho mob nrog COVID-19 lossis mob khaub thuas thiab kho rau cov xwm txheej hauv qab uas siv qhov sib piv hnyav. Tag nrho ntawm 3402 lub tsev kho mob rau COVID-19 thiab 3680 lub tsev kho mob rau tus mob khaub thuas tau txais thaum Lub Kaum Hli 1, 2019, thiab Tsib Hlis 31, 2020, hla 127 Veterans Administration tsev kho mob thoob tebchaws tau kawm siv cov ntaub ntawv kho mob hluav taws xob. Mob hnyavraumraug mobtshwm sim ntau zaus ntawm cov neeg muaj COVID-19 piv rau cov neeg mob khaub thuas (40.9 feem pua piv rau 29.4 feem pua , ntsuas qhov hnyav) thiab hnyav dua. Cov neeg mob nrog COVID-19 feem ntau yuav xav tau cov tshuab ua pa thiab vasopressors thiab ntsib kev tuag ntau dua. Proteinuria thiab hematuria tau nquag hauv ob pawg tab sis ntau dua hauv COVID-19. Rov qab ntawmraummuaj nuj nqitsis tshua muaj tshwm sim hauv cov neeg mob nrog COVID-19 thiab mob hnyavraumraug mobtab sis zoo ib yam ntawm cov muaj sia nyob. Yog li, kev tshawb pom los ntawm txoj kev tshawb fawb no tau lees paub tias mob raum raug mob ntau dua thiab hnyav ntawm cov neeg mob pw hauv tsev kho mob nrog COVID-19 piv rau tus mob khaub thuas, qhov kev tshawb pom uas yuav ua rau muaj mob hnyav heev. Yog li ntawd, kev sib koom ua ke ntawm ob yam mob no rauraumnoj qab haus huvtuaj yeem yog qhov tseem ceeb thiab muaj feem cuam tshuam rau kev faib cov peev txheej.

KEYWORDS: mobraumraug mob; COMD -19; hematuria; mob khaub thuas; proteinuria luam tawm los ntawm Elsevier, Inc., sawv cev ntawm International Society of Nephrology.

Mob hnyavraumraug mob(AKI) yog ib qho teeb meem pom zoo ntawm tus mob hnyav ua pa nyuaj ua pa mob coronavirus 2 (SARS-CoV-2)(coronavirus disease 2019 [COVID-19]), LLC

tshwm sim hauv ib feem peb ntawm cov neeg mob pw hauv tsev kho mob thiab txog li peb feem pua ntawm cov neeg mob hnyav, nrog rau cov neeg mob hauv tsev kho mob muaj feem cuam tshuam txog li 50 feem pua. Tus nqi siab ntawm hematuria thiab proteinuria kuj tau pom hauv COVID-19.

Qhov twg qhov kev tshawb pom no txawv ntawm lwm yam kab mob ua pa hnyav tsis paub. Txawm hais tias muaj kev sib piv tsis raug rau tus mob khaub thuas tau ua, qee qhov kev sib piv ncaj qha tau ua. Cov ntawv nyeem ntawm AKI nyob rau hauv tus mob khaub thuas qhia txog qee yam kev pheej hmoo uas tshwm sim rau ob qho kev mob, xws li muaj feem cuam tshuam txog kev mob hnyav (xws li, mob hnyav thiab lub tshuab ua pa). Ib yam li ntawd, cov cim kev mob hnyav tau pom nyob rau hauv ob qho mob khaub thuas thiab COVID-19 thiab feem ntau cuam tshuam nrog AKI,,2 thaum cov ntaub ntawv histopathologic thiab cov kev tshawb fawb soj ntsuam pom tau tias kev raug mob ischemic raws li qhov tseem ceeb etiology ntawm AKI nyob rau hauv ob qho tib si mob.{{2} }Kev nkag siab ntxiv ntawm cov txheeb ze thiab kev sib koom ua ke ntawm AKI hauv 2 tus mob no yog qhov tseem ceeb. Peb tau xav tias cov neeg mob nrog COVID-19 yuav muaj tus nqi siab dua thiab qhov hnyav ntawm AKI dua li cov neeg mob zoo sib xws hauv tsev kho mob khaub thuas. Txhawm rau ntsuas qhov kev xav no, peb muab piv rau qhov tshwm sim, muaj feem cuam tshuam, cov yam ntxwv kho mob, thiab rov qab los ntawm AKI hauv kev tshawb nrhiav rov qab ntawm cov neeg mob qub tub rog nyob hauv tsev kho mob nrog COVID-19 lossis mob khaub thuas.

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Txoj kev

Kawm kev teeb tsa thiab tsim qauv

Peb tau ua txoj kev tshawb fawb txog kev rov qab los ntawm lub teb chaws ntawm cov qub tub rog, muaj hnub nyoog Ntau dua lossis sib npaug li 18 xyoo, uas tau txais los ntawm COVID-19 lossis mob khaub thuas thaum Lub Kaum Hli 1, 2019, thiab Lub Tsib Hlis 31, 2020. Cov ntaub ntawv tau txais los ntawm kev noj qab haus huv hluav taws xob Cov ntaub ntawv siv los ntawm Veterans Affairs (VA) Kev Tswj Xyuas Kev Noj Qab Haus Huv, uas yog tsim los ntawm Veterans Health Information and Technology Architecture thiab Computerized Patient Record System. Txoj kev tshawb no tau pom zoo los ntawm Pawg Saib Xyuas Kev Tshawb Fawb thiab Pawg Tshawb Fawb thiab Kev Txhim Kho ntawm Tennessee Valley Healthcare System VA. Qhov yuav tsum tau muaj kev pom zoo raug zam vim qhov tsis muaj peev xwm tau txais kev tso cai pom zoo rau ib pawg neeg loj hauv tebchaws.

Cov ntaub ntawv khaws tseg

Cov ntaub ntawv txij lub Kaum Hlis 1, 2018, txog rau lub Cuaj Hlis 24, 2020, tau sau los ntawm Observational Medical Outcomes Partnership version 5 common data model transformation of the National Corporate Data Warehouse, which aggregates data from all VA cov chaw, thiab VA COVID{{5} } Cov ntaub ntawv sib koom ua ke.20-2 Cov ntaub ntawv kho mob hauv tsev kho mob ua tiav muaj rau txhua tus neeg mob. Cov ntaub ntawv qhia txog kev sib kis kab mob hauv nruab nrab tau txais los ntawm cov ntaub ntawv muaj nyob rau hnub ntawm kev nkag mus hauv tsev kho mob. Cov neeg mob hauv tsev kho mob, cov cim tseem ceeb, cov ntaub ntawv kuaj mob, thiab cov ntaub ntawv raug tau txais los ntawm cov ntaub ntawv nkag los ntawm kev tso tawm.Lub raummuaj nuj nqithiab cov txiaj ntsig kev tuag tau raug sau los ntawm VA cov ntaub ntawv kuaj mob, kev kuaj xyuas kev tswj hwm thiab cov txheej txheem txheej txheem, thiab VA cov ntaub ntawv tseem ceeb. Kev kuaj mob thiab cov txheej txheem raug txiav txim siab siv International Classification of Diseases, Ninth Revision (ICD-9), International Classification of Diseases, Tenth Revision (ICD-10), thiab Current Procedural Terminology codes (Table Supplementary Table S1). Cov kev xeem kuaj tau raug txheeb xyuas los ntawm Kev Tshawb Fawb Txog Kev Tshawb Fawb Cov Npe thiab Cov Cai. Cov tshuaj tau txais los ntawm tus neeg mob sab nraud VA lub tsev muag tshuaj sau cov ntaub ntawv thiab tus neeg mob hauv tsev kho mob barcoded noj tshuaj thiab categorized siv Anatomical Therapeutic Chemical classification thiab RxNorm.

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Cov txheej txheem cais tawm ntawm pawg

Nyob rau hauv lub sijhawm kawm ua ntej thiab thoob plaws 127 VA tsev kho mob thoob tebchaws, peb tau txheeb xyuas 8454 lub tsev kho mob uas suav nrog kev kuaj mob ntawm COVID-19 lossis mob khaub thuas. Cov txheej txheem tsim nyog suav nrog tus nqi ntawm tus neeg mob premorbid creatinine tus nqi thiab tsawg kawg yog 1 tus neeg mob ntshav qab zib creatinine tus nqi lossis yam tsawg kawg 2 ntshav creatinine qhov tseem ceeb hauv qhov tsis muaj tus nqi premorbid. Peb tau siv ntau yam kev cais tawm los muab 2 qhov chaw kho mob muaj feem cuam tshuam, raws li tau piav qhia hauv daim duab 1. Peb tsis suav cov neeg mob uas tau txais kev kho mob nephrectomy thaum mus pw hauv tsev kho mob thiab cov neeg mob uas muaj qhov ntsuas qhov ntsuas glomerular filtration rate (eGFR)<15 ml/min="" per="" 1.37="" m²,="" kidney="" transplantation,="" or="" end-stage="" renal="" disease="" before="" index="" hospitalization.="" in="" patients="" who="" had="">1 tsim nyog tau mus pw hauv tsev kho mob thaum lub sijhawm kawm, peb txwv rau thawj qhov tsim nyog tau pw hauv tsev kho mob. Cov neeg mob uas muaj qhov zoo ntawm COVID-19 thiab kuaj mob khaub thuas thaum lub sijhawm kawm tsis suav nrog.

Lus txhais

Thawj qhov tshwm sim hauv qhov kev tshawb fawb no tau kis tus kab mob COVID{{0}} lossis mob khaub thuas. Ob pawg tau txhais: (i) cov neeg mob uas muaj qhov zoo ntawm COVID-19 kuaj hauv 14 hnub ua ntej lossis thaum mus pw hauv tsev kho mob; thiab (ii) cov neeg mob uas muaj tus mob khaub thuas A lossis mob khaub thuas B kuaj tsis pub dhau 14 hnub ua ntej lossis thaum mus pw hauv tsev kho mob. Cov neeg mob tau kuaj pom tias muaj tus kab mob COVID-19 lossis mob khaub thuas los ntawm polymerase saw cov tshuaj tiv thaiv los yog kuaj cov tshuaj tiv thaiv sai ntawm nasopharyngeal, oropharyngeal, lossis cov qauv ua pa. Cov txiaj ntsig tseem ceeb hauv txoj kev tshawb no yog AKI. AKI tau txhais los ntawm kev siv lub ncov hauv tsev kho mob ntshav creatinine thiab theem siv cov kab mob hauv lub raum hloov kho: Txhim kho Cov txiaj ntsig thoob ntiaj teb (KDIGO) cov txheej txheem creatinine-raws li: theem 1, Ntau dua lossis sib npaug rau 0.3 mg / dl creatinine nce los ntawm lub hauv paus los yog creatinine 1.5 mus rau 1.9 npaug ntawm lub hauv paus; theem 2, creatinine 2.0 mus rau 2.9 npaug ntawm lub hauv paus; thiab theem 3, creatinine 3.0 zaug hauv paus los yog pib ntawm kev lim ntshav. Txhawm rau kom sib piv AKI kom raug thiab rov ua kom zoo dua qub, peb nyiam ua kom peb cov lus txhais rau cov kab hauv qab uas paub txog creatinine, uas muaj nyob rau hauv 84 feem pua ntawm cov neeg mob nrog COVID-19 thiab 92 feem pua ntawm tus mob khaub thuas. Cov txiaj ntsig thib ob suav nrog hematuria, proteinuria, kho raum hloov kho,

Daim duab 1 Cohort xaiv flow diagram. Cov txheej txheem cais tawm tau siv rau cov tsev kho mob tsim nyog tau txais cov pab pawg kawm zaum kawg. COVID-19, kab mob coronavirus 2019; ESRD, kab mob raum kawg.

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