肾移植患者COVID-19术后1年随访中影响肾功能的因素

H. Ozer, I. Baloglu, Yasin Öztürk, Fethi Yönet, H. Tonbul, N. Selcuk, Kultigin Türkmen
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摘要

背景冠状病毒病(COVID-19)在肾移植(KTx)患者中更为严重,死亡率更高;新冠肺炎后肾脏功能的进展和影响肾功能的情况尚不清楚。我们旨在探讨COVID-19后肾脏功能的变化及其影响因素。材料与方法回顾性分析41例因COVID-19住院的肾移植患者。从医院系统获取患者的个人信息、检查信息、住院和随访的治疗信息。结果新冠肺炎后1年内血清肌酐升高的患者基线蛋白尿和全身免疫炎症指数(SII)较高。在移植期长、高血压、高基础肌酐和SII患者中,蛋白尿增加更多。此外,在COVID期间发生AKI的患者中蛋白尿较高。此外,基线SII是血清肌酐和蛋白尿变化的独立预测因子。结论:我们发现有炎症增加迹象的患者,如高SII,在肾功能方面更脆弱。因此,KTx患者COVID-19后随访过程应个体化。
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Factors Affecting Kidney Functions in One-Year Follow-up After COVID-19 in Kidney Transplant Patients
Background Coronavirus disease (COVID-19) is more severe, and mortality is higher in kidney transplantation (KTx) patients; it is still unclear how renal functions progress and the conditions affecting renal functions in the post-COVID-19 period. We aimed to investigate the changes in kidney functions and the factors affecting this change after COVID-19. Material and Methods Forty-one kidney transplantation patients who were hospitalised for COVID-19 were included in this retrospective study. The patient's personal information, examination, and treatment information regarding their hospitalisation and follow-ups were obtained from the hospital system. Results Patients with elevated serum creatinine in the first year post-COVID had higher baseline proteinuria and systemic immune inflammation index (SII). Proteinuria increased more in patients with a long transplantation period, hypertension, high basal creatinine, and SII. Also, proteinuria was higher in patients who developed AKI during the COVID period. In addition, baseline SII was an independent predictor of the change in serum creatinine and proteinuria. Conclusions We found that patients with signs of increased inflammation, such as high SII were more fragile regarding renal functions. Therefore, the post-COVID-19 follow-up process of KTx patients with COVID-19 should be individualised.
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