COVID-19: mortality rates of patients on hemodialysis and peritoneal dialysis

Abstract

Objective Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection might have a higher mortality rate in patients with end-stage renal disease due to immunosuppression. This study investigates the mortality rates of SARS-CoV-2 infection and the factors affecting mortality among patients who were on maintenance hemodialysis and continuous ambulatory peritoneal dialysis. Materials and methods A total of 200 patients, including 157 maintenance hemodialysis and 43 continuous ambulatory peritoneal dialysis patients followed in our hospital, were included in the study. The patients' sociodemographic characteristics, comorbidities, history of SARS-CoV-2 infection in the previous year, death event, source of death (SARS-CoV-2 or not), presence of hospitalization due to SARS-CoV-2 infection, need for intensive care unit, need for ventilatory support in intensive care unit were obtained from the clinical file records. Results 85 of the 200 patients had a history of SARS-Cov-2 infection during the last 12 months. Forty-two (49.5%) patients with SARS-CoV-2 infection were hospitalized. Patients with SARS-CoV-2 had longer dialysis time, increased mortality, and significantly higher comorbidities such as coronary artery disease, congestive heart failure. Besides, heart failure and hypertension were the determining factors in the risk factor analysis for SARS-CoV-2 infection. In dialysis patients, the mortality rate in the last year, due to all causes, including SARS-CoV-2 infection, was 23% while the mortality rate due to "SARS-CoV-2 infection only" was 13%) ( p > 0.05). Our findings are important in guiding clinical decision-making and informing the public and health authorities about the risk of death associated with COVID-19 in this patient group.

Fatality rate, risk factors, and functional decline in peritoneal dialysis patients with coronavirus disease 2019: A nationwide cohort study

“…The COVID-19-related fatality rate among PD patients is poorly understood. Most studies included only a limited number of PD patients, ranging from two to thirty in each trial ( 2 , 13 , 20 – 23 ). We demonstrated that the early COVID-19-related fatality rate for PD patients was at least comparable to those of PD patients from the other studies ( 2 , 13 , 20 – 23 ).…”

“…Most studies included only a limited number of PD patients, ranging from two to thirty in each trial ( 2 , 13 , 20 – 23 ). We demonstrated that the early COVID-19-related fatality rate for PD patients was at least comparable to those of PD patients from the other studies ( 2 , 13 , 20 – 23 ). In a large multicenter European registry consisting of 768 patients on maintenance dialysis and only 4% of study participants on chronic PD therapy, Hillbrands et al observed a fatality rate of 30% in the PD group at 28 days after COVID-19 diagnosis, compared to a fatality rate of 25% for all dialysis patients ( 2 ).…”

“…The majority of the COVID-19 mortality data and clinical outcomes are derived from the HD and kidney transplant (KT) populations ( 2 , 8 , 9 ). A few studies, primarily case series or small cohorts with a limited number of PD patients, have examined those outcomes of the PD population ( 10 – 13 ). Earlier studies showed that fatigue and myalgia were prevalent among ESKD patients diagnosed with COVID-19, ranging from 3 to 63% ( 14 ).…”

Vaccination and mortality from COVID-19: a comparative study between hemodialysis, peritoneal dialysis, and non-dialysis adult population in Panama

“…Some studies have demonstrated that PD patients had less COVID-19 infection rate than HD patients [ 14 ]. There are other reports indicating that mortality in PD patients was higher than HD patients, probably due to some comorbidities; in our case, PD patients had more diabetes, but not older age [ 15 ].…”

Outcomes of COVID-19 in peritoneal dialysis patients: A report by the European Renal Association COVID-19 Database

“…5,6 To date only few and relatively small series of PD patients with COVID-19 have been described, 7,8 some as part of articles that also describe other dialysis patient groups. 2,[9][10][11][12] An European Renal Association (ERA) Registry report compared 125 PD patients with 3126 HD patients and showed that there was no statistically significant difference between PD and HD patients, although the adjusted probability of death at day 28 was higher in PD patients (21.6%) than in HD patients (18.0%). 2 Unfortunately, details of the disease course and treatment were not available in this cohort.…”