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目的:分析新型冠状病毒肺炎（新冠肺炎）患者发生急性肾损伤（AKI）的临床特征，并寻找相关危险因素。方法:采用回顾性队列研究，分析2020年1月1日至2月1日在武汉大学中南医院、武汉市第四医院住院治疗的新冠肺炎患者基础资料、临床特征以及预后相关信息。根据改善全球肾脏病预后组织（KDIGO）AKI诊断标准，将发生AKI的患者纳入AKI组，未发生AKI的患者纳入非AKI组，比较两组患者各指标的差异；采用Kaplan-Meier生存曲线和Cox回归方法，分析AKI对新冠肺炎患者预后的影响。结果:共纳入394例新冠肺炎患者，整体病死率为5.6%；37例（9.4%）发生新冠肺炎相关性AKI，新冠肺炎相关性AKI患者病死率达18.9%。是否发生AKI两组患者间年龄、性别、吸烟史、高血压史、恶性肿瘤史、心血管疾病史及脑血管疾病史差异均有统计学意义。在实验室检查结果中，除血清肌酐（SCr）和血尿素氮（BUN）等直接反映肾功能的指标外，新冠肺炎相关性AKI患者的白细胞计数（WBC）、中性粒细胞计数（NEU）、天冬氨酸转氨酶（AST）、乳酸脱氢酶（LDH）、D -二聚体、降钙素原（PCT）及C -反应蛋白（CRP）均较非AKI患者显著升高〔WBC（×10n 9/L）：5.75（4.13，7.83）比4.52（3.35，5.90），NEU（×10n 9/L）：4.55（2.81，6.11）比3.06（2.03，4.50），AST（U/L）：40.0（24.5，69.5）比30.0（23.0，42.5），LDH（μmol·sn -1·Ln -1）：5.21（3.68，7.57）比4.24（3.05，5.53），D -二聚体（μg/L）：456（266，2 172）比290（152，610），PCT（μg/L）：0.33（0.03，1.52）比0.01（0.01，0.11），CRP（mg/L）：53.80（26.00，100.90）比23.60（9.25，51.10），均n P<0.05〕，淋巴细胞计数（LYM）、血小板计数（PLT）显著下降〔LYM（×10n 9/L）：0.68（0.47，1.05）比0.91（0.63，1.25），PLT（×10n 9/L）：142.0（118.0，190.0）比171.0（130.0，2 190.0），均n P<0.05〕。AKI组病死率显著高于非AKI组〔18.9%（7/37）比4.2%（15/357），n P<0.01〕；Kaplan-Meier生存曲线显示，AKI组30 d累积存活率低于非AKI组（log-rank：n P＝0.003）；Cox回归分析显示，新冠肺炎相关性AKI能使新冠肺炎患者的病死率提高约3.2倍〔风险比（n HR）＝3.208，95%可信区间（95%n CI）为1.076～9.566，n P＝0.037〕。n 结论:新冠肺炎相关性AKI发生率较高，对具有AKI风险的新冠肺炎患者早期进行干预和预防对改善患者预后具有重要意义。“,”Objective:To investigate the characteristics and the risk factors of coronavirus disease 2019 (COVID-19) associated acute kidney injury (AKI).Methods:A retrospective cohort study was performed to examine the basic data, clinical characteristics and prognosis of patients with COVID-19 in Zhongnan Hospital of Wuhan University and Wuhan Fourth Hospital from January 1st to February 1st in 2020. According to the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO), patients with AKI were included in AKI group and those without AKI were included in non-AKI group. The differences of each index between the two groups were compared. The prognostic value of AKI for COVID-19 was analyzed by Kaplan-Meier survival curve and Cox regression.Results:A total of 394 COVID-19 patients were included, with a total mortality of 5.6%; 37 (9.4%) of them developed AKI. The mortality of patients with COVID-19 associated AKI was 18.9%. There were significant differences in age, gender, smoking history, hypertension history, malignancy history, cardiovascular disease history and cerebrovascular disease history between the two groups. In addition to the difference of serum creatinine (SCr) and blood urea nitrogen (BUN), white blood cell count (WBC), neutrophil count (NEU), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), D-dimer, procalcitonin (PCT) and C-reaction protein (CRP) in AKI group were significantly higher than those in non-AKI group [WBC (×10n 9/L): 5.75 (4.13, 7.83) vs. 4.52 (3.35, 5.90), NEU (×10n 9/L): 4.55 (2.81, 6.11) vs. 3.06 (2.03, 4.50), AST (U/L): 40.0 (24.5, 69.5) vs. 30.0 (23.0, 42.5), LDH (μmol·sn -1·Ln -1): 5.21 (3.68, 7.57) vs. 4.24 (3.05, 5.53), D-dimer (μg/L): 456 (266, 2 172) vs. 290 (152, 610), PCT (μg/L): 0.33 (0.03, 1.52) vs. 0.01 (0.01, 0.11), CRP (mg/L): 53.80 (26.00, 100.90) vs. 23.60 (9.25, 51.10), alln P < 0.05], while lymphocyte count (LYM) and platelet count (PLT) were decreased [LYM (×10 n 9/L): 0.68 (0.47, 1.05) vs. 0.91 (0.63, 1.25), PLT (×10n 9/L): 142.0 (118.0, 190.0) vs. 171.0 (130.0, 2 190.0), both n P < 0.05]. The mortality of AKI group was significantly higher than that of non-AKI group [18.9% (7/37) vs. 4.2% (15/357), n P < 0.01]. Kaplan-Meier survival curve showed that the 30-day cumulative survival of AKI group was lower than that of non-AKI group (log-rank: n P = 0.003). Cox analysis also showed that AKI increased the odds of patients with COVID-19 mortality by 3.2-fold [hazard ratio (n HR) = 3.208, 95% confidence interval (95%n CI) was 1.076-9.566, n P = 0.037].n Conclusions:The risk of AKI is higher in patients with COVID-19. Early intervention to prevent AKI in patients with COVID-19 is of great significance to improve the prognosis of patients.