فراوانی اختلالات ادراری، الکترولیتی و عملکردی کلیه در بیماران مبتلا به کووید 19 در سطح بیمارستان‌های تابعه دانشگاه علوم پزشکی آزاد اسلامی تهران در سال های 1401-1398

ﺳﺎﺑﻘﻪ و ﻫﺪف: ﻛﻮوﻳﺪ19، پاندمی ﻧﻮﻇﻬﻮر ﻛﺸﻨﺪه، ﻣﺴﺮی و ﻋﻮارض ﺑﺎﻻ ﻣﻌﺮﻓﻲ ﺷﺪه ﻛﻪ ﺗﺎﺛﻴﺮات ﻧﺎﮔﻮاری ﺑﺮ ارﮔﺎنﻫﺎ دارد. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﺛﺮات ﻣﺒﻬﻢ ﺑﻴﻤﺎری ﺑﺮ ﺳﻴﺴﺘﻢ ﻛﻠﻴﻮی- ادراری، اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﻌﻴﻴﻦ ﻓﺮاواﻧﻲ اﺧﺘﻼﻻت ادراری، الکترولیتی و ﻋﻤﻠﻜﺮدی ﻛﻠﻴﻪ اﻧﺠﺎم ﺷﺪ. روش بررسی: در اﻳﻦ ﻣﻄﺎﻟﻌﻪ 518 ﺑﻴﻤﺎر ﻣﺒﺘﻼ ﺑﻪ ﻛﻮوﻳﺪ19 ﺑﺴﺘﺮی در ﺑﻴﻤﺎرﺳﺘﺎنﻫﺎی داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ آزاد اﺳﻼﻣﻲ ﺗﻬﺮان، ﺑﻴﻦ ﻓﺮوردﻳﻦ1398ﺗﺎ اردﻳﺒﻬﺸﺖ 1401، ﺑﺎ داﺷﺘﻦ ﻣﻌﻴﺎرﻫﺎی ورود اﻧﺘﺨﺎب ﺷﺪﻧﺪ. ﭘﺎراﻣﺘﺮﻫﺎی دﻣﻮﮔﺮاﻓﻴﻚ ﺳﻦ و ﺟﻨﺴﻴﺖ و آزﻣﺎﻳﺸﮕﺎﻫﻲ اﺧﺘﻼﻻت ﻋﻤﻠﻜﺮدی ، ادراری، الکترولیتی از ﭘﺮوﻧﺪهﻫﺎی ﺑﻴﻤﺎران اﺳﺘﺨﺮاج و بررسی ﺷﺪ ﻳﺎﻓﺘﻪﻫﺎ: ﻓﺮاواﻧﻲ ﻣﺮگ 6/5 درﺻﺪ ﺑﻮد. درﻣﻘﺎﻳﺴﻪ ﺑﻴﻤﺎران ﻓﻮﺗﻲ ﻧﺴﺒﺖ ﺑﻪ ﺑﻬﺒﻮدﻳﺎﻓﺘﻪ، ﺳﻦ 11/60 ± 67/7 در ﻣﻘﺎﺑﻞ 10/50 ± 59/07 ﺳﺎل؛ 0/032 = p ، ﻛﺮاﺗﻴﻨﻴﻦ 1/08 ± 1/64 در ﻣﻘﺎﺑﻞ 0/69 ± 1/17 ﻣﻴﻜﺮوﻣﻮل/ﻟﻴﺘﺮ ، اوره 77/55 ± 91/06 در ﻣﻘﺎﺑﻞ 30/17 ± 39/48 ﻣﻴﻠﻲ- ﻣﻮل/ ﻟﻴﺘﺮ ﺑﺎ ﺗﻔﺎوت ﺑﺎﻻﺗﺮ و gfr 22/28 ± 47/04 در ﻣﻘﺎﺑﻞ 22/54 ± 65/72 ﻣﻴﻠﻲﻟﻴﺘﺮ/ دﻗﻴﻘﻪ ﭘﺎﻳﻴﻦﺗﺮ ﺑﻮد0/001 < p . ﻓﺮاواﻧﻲ ﻣﺮگ ﺑﺎ ﻛﺮاﺗﻨﻴﻦ ﺑﺎﻻ 3/78 =rr ، اوره 5/83 =p= 0/001 rr و gfr ﭘﺎﻳﻴﻦ 3/17 =p= 0/021 rr راﺑﻄﻪ داﺷﺖ. ﻓﺮاواﻧﻲ ﻣﺮگ در ﻣﺮدان 0/025 = p ، ﻫﻴﭙﺮﻛﺎﻟﻤﻲ 0/002 = p و آﻟﻜﺎﻟﻮز 0/037 = p ﺑﺎ ﺗﻔﺎوت ﺑﺎﻻﺗﺮ ﺑﻮد. ﻧﺘﻴﺠﻪﮔﻴﺮی: ﺑﺮ اﺳﺎس ﻧﺘﺎﻳﺞ، ﺷﻨﺎﺧﺖ ﺳﺮﻳﻊ ﺑﻴﻤﺎران دارای ﺧﻄﺮ آﺳﻴﺐ ﻛﻠﻴﻮی و آﻣﺎدﮔﻲ ﺟﻬﺖ ﻛﻨﺘﺮل ﻓﺎﻛﺘﻮرﻫﺎی ﺧﻄﺮ و ﺑﺮﻧﺎﻣﻪرﻳﺰی ﺑﺮای ﭘﻴﺸﮕﻴﺮی و ﺗﺸﺨﻴﺺ و درﻣﺎن ﺑﻪﻣﻮﻗﻊ در ﻣﺮاﺣﻞ اوﻟﻴﻪ، ﺿﺮوری اﺳﺖ و اﻧﺠﺎم آن ﭘﻴﺸﻨﻬﺎد می شود.

prevalence of urinary abnormality, electrolytes disorders and renal insufficiency in covid-19 patients in affiliated hospitals of islamic azad university, tehran medical sciences, 2019-2022

background: covid-19 is a deadly, contagious and highly complicated virus, with adverse effects on various organs. considering the ambiguous effects of covid-19 on the renal-urinary system, this study was conducted to determine the frequency of urinary, electrolyte and kidney disorders in these patients. materials and methods: in this study, 518 patients with covid-19 admitted to the affiliated hospitals of iautm islamic azad university, tehran medical sciences from march 2019 to april 2022, were studied. demographic age and gender , and laboratory parameters functional, urinary and electrolytes disorders were extracted from the clinical charts. results: the mortality rate was 6.5%. in deceased patients compared to recovered patients, age 67.7 ± 11.60 vs. 59.07 ± 10.50 years p= 0.032 , creatinine 1.64 ± 1.08 vs. 1.17 ± 0.69 μ mol/l p± 0.001 and urea 91.06 ± 77.55 vs. 39.48 ± 30.17 mmol/l p± 0.001 were significantly higher and gfr 47.04 ± 22.28 vs. 65.72 ± 22.54 ml/min p± 0.001 was significantly lower. there was a significant relationship between mortality rate and increased creatinine level rr= 3.78 p= 0.001 , high urea rr= 5.83 p= 0.001 and low gfr rr= 3.17 p= 0.021 . the frequency of death was significantly higher among men p= 0.025 , and patients with hyperkalemia p= 0.002 and or alkalosis p= 0.037 .conclusion: based on the results, faster screening and treating patients with risk factors of kidney damage is necessary and recommended.