Нemodialiasis和COVID-19(对马哈奇卡拉大流行第一年的分析)

P. G. Gadzhieva, Z. A. Agalavova, M. J. Gadzhiyavdibirova, L. B. Gasanova
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摘要

背景。接受程序性血液透析治疗的患者发生COVID-19的风险很高。目的:分析Makhachkala地区接受程序性血液透析治疗的COVID-19患者的临床情况、病程特点、危险因素和治疗方案。患者和方法。162名因终末期肾衰竭而接受HD治疗的患者(87名男性和75名女性)在Makhachkala的GBU RD“RKB”接受观察,该中心于2019年4月至2020年4月期间被重新用于为SARS-CoV-2感染的患者提供医疗护理。该研究为单中心、回顾性和非对照研究。观察的终点被认为是患者出院或死亡。在研究结束时继续治疗的患者被排除在外。结果。101例(62.3%)患者感染了SARS-CoV-2,其余患者通过胸部器官CT确定的特征性模式得到证实。COVID-19在HD患者中的致命结果与更严重和更广泛的肺部病变(CT-3和CT-4)相关,与存活患者相比,这种病变的诊断频率要高得多。在相当数量的终末期CKD合并HD治疗的患者中,其特点是病程严重,预后不良。在这方面,有必要在感染和严重COVID-19风险增加的群体中寻找有效和安全的预防和治疗方法。结论。CKD患者发生严重COVID-19的风险增加。伴随的心血管疾病和糖尿病可能易患此病。鉴于疫苗的可用性或批准的治疗方法,肾病学家应建议CKD患者遵循社会隔离的建议。©2022教育自治非营利组织肾脏病。版权所有。
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НEMODIALIASIS AND COVID-19 (ANALYSIS OF THE FIRST YEAR OF THE PANDEMIC IN MAKHACHKALA)
BACKGROUND. Patients receiving treatment with programmed hemodialysis are at high risk for the incidence of COVID-19. THE AIM: to analyze the clinical picture, features of the course, risk factors and treatment options in COVID-19 patients treated with programmed hemodialysis in Makhachkala. PATIENTS AND METHODS. 162 patients (87 men and 75 women) were treated with HD for terminal renal failure were under observation in the GBU RD "RKB" of Makhachkala, repurposed to provide medical care to patients infected with SARS-CoV-2 from April 2019 to April 2020. The study was single-center, retrospective and uncontrolled. The end point of observation was considered to be the patient's discharge from the hospital or death. Patients who continued treatment at the end of the study were excluded from it. RESULTS. Infection with SARS-CoV-2 in 101 (62.3%) patients was confirmed by PCR results, and in the rest – by a characteristic pattern determined by CT of the chest organs. The fatal outcome of COVID-19 in patients with HD was associated with a more severe and widespread lung lesion (CT-3 and CT-4), which was diagnosed significantly more often compared to the surviving patients. In a significant number of patients with end-stage CKD treated with HD, it is characterized by a severe course and an unfavorable prognosis. In this regard, there is a need to search for effective and safe methods of prevention and treatment in groups at increased risk of infection and severe COVID-19. CONCLUSION. Patients with CKD have an increased risk of developing severe COVID-19. Concomitant cardiovascular diseases and diabetes mellitus may predispose to this. Given the availability of a vaccine or approved therapy, nephrologists should advise patients with CKD to follow the recommendations of social isolation. © 2022 Educational Autonomous Non-Profit Organization Nephrology. All rights reserved.
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