Factorii de progresie ai bolii cronice de rinichi la pacienţii cu COVID-19

Abstract

Introducere. în prezent, COVID-19 este recunoscută ca fiind o boală multisistemică cu o gamă largă de manifestări. Una dintre cele mai frecvente complicaţii este progresia bolii cronice de rinichi (BCR). Scopul studiului: evidenţierea factorilor de progresie a bolii cronice de rinichi la pacienţii spitalizaţi cu COVID-19. Materiale şi metode. Studiul a inclus 1000 de pacienţi spitalizaţi cu COVID-19 (în cadrul SCR ’’Timofei Moşneaga") pe parcursul anilor 2020-2022 cu diferite comorbidităţi (inclusiv BCR) şi s-a efectuat o analiză clinico-biochimică a sângelui (sindroamele inflamator, renal, hepatic etc). Prelucrarea statistică a datelor obţinute a fost realizată prin StatSoft STATISTICA 9.0. Rezultate. Ca urmare a studiului, factori de progresie pentru BCR s-au constatat vârsta (71 (51;83) vs. 62 (49;71) ani, respectiv, p < 0,001), comorbidităţi: hipertensiune arterială (74% vs. 62%, p < 0,01), diabet zaharat tip 2 (27% vs. 21%, p = 0,017), boli cardiovasculare (31% vs. 23%, p < 0,05), inclusiv Charlson Comorbidity Index relativ mare (5 (2;6) vs 3 (1;4), p < 0,0001). Concluzii. Factori predictivi negativi independenţi ai BCR dezvoltate post-COVID-19 au fost hipertensiunea arterială, asociativă bolilor cardiovasculare şi vârstei, indicele Charlson >4 puncte şi diabetul zaharat tip 2 (cu deficienţe de control) asociativ obezităţii. Pacienţii care aveau BCR în faza acută a COVID-19 de peste 2,5 ori creşte riscul de deces şi de progresie a BCR.

Background. Currently, COVID-19 is recognized as a multisystem disease with a wide range of manifestations. One of the most common complications is the progression of chronic kidney disease (CKD). Objective of the study. Highlighting factors of progression of chronic kidney disease in hospitalized patients with COVID-19. Materials and methods. The study included 1000 patients hospitalized with COVID-19 (within Timofei Moşneaga Republican Clinical Hospital) during 2020-2022 with different comorbidities (including CKD) and a clinical-biochemical analysis of blood (inflammatory, renal, hepatic syndromes, etc.) were performed. The statistical processing of the obtained data was carried out by StatSoft STATISTICA 9.0. Results. As a result of the study, progression factors for CKD were found age (71 (51; 83) vs 62 (49; 71) years, respectively, p < 0.001), comorbidities: hypertension (74% vs 62%, p < 0.01), type 2 diabetes mellitus (27% vs 21%, p = 0.017), cardiovascular disease (31% vs 23%, p < 0.05), including relatively high Charlson Comorbidity Index (5 (2; 6) vs 3 (1; 4), p < 0.0001). Conclusions. Independent negative predictors of post-COVID-19 CKD were hypertension, associative of cardiovascular disease and age, Charlson index >4 points, and type 2 diabetes mellitus (with impairment control) associative to obesity. Patients who had CKD in the acute phase of COVID-19 more than 2.5 times increase the risk of death and progression of CKD.