Impact of First Wave COVID-19 Crisis on Dialysis Parameters of COVID-Free Hemodialysis Patients: A NephoCare France Longitudinal Retrospective Cohort Study

Chazot, Charles; Weis, Lise; Hebibi, Hadia; Jean, G.; Deleuze, S.; Levannier, Martial; Attaf, David; Stuard, Stefano

doi:10.1159/000517493

Cited by 4 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The rate of hospitalization unrelated to COVID-19 also declined significantly 25 , suggesting difficulties in accessing care. In addition, logistical constraints during the first wave resulted in decreased weekly dialysis time in non-infected patients 30 . Furthermore, a sharp reduction in kidney transplantation occurred during the first wave in 22 countries worldwide 31 .…”

Section: Disease Coursementioning

confidence: 99%

COVID-19 in dialysis: clinical impact, immune response, prevention, and treatment

Karoui

Vriese

2022

Kidney International

112

View full text Add to dashboard Cite

Section: Disease Coursementioning

confidence: 99%

COVID-19 in dialysis: clinical impact, immune response, prevention, and treatment

Karoui

Vriese

2022

Kidney International

112

View full text Add to dashboard Cite

“…Therefore, it is conceivable that the modifications of the usual medical care also had an influence on the clinical management and outcomes of diseases not directly related to COVID-19. In this regard, a recent large retrospective study on a French cohort of hemodialysis patients (HD) showed that the quality of HD delivered to COVID-19-free HD patients was negatively impacted because of the strong constraints on Nephrology units’ organization related to the pandemic [ 8 ]. Consistently, in this study, we investigated whether the COVID-19 pandemic could have had an impact on intrahospital AKI incidence and outcomes.…”

Section: Introductionmentioning

confidence: 99%

Changes of Acute Kidney Injury Epidemiology during the COVID-19 Pandemic: A Retrospective Cohort Study

Esposito

Russo

Picciotto

et al. 2022

JCM

View full text Add to dashboard Cite

To evaluate the impact of the Coronavirus Disease-19 (COVID-19) pandemic on the epidemiology of acute kidney injury (AKI) in hospitalized patients, we performed a retrospective cohort study comparing data of patients hospitalized from January 2016 to December 2019 (pre-COVID-19 period) and from January to December 2020 (COVID-19 period, including both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative and positive patients). AKI was classified by evaluating the kinetics of creatinine levels. A total of 51,681 patients during the pre-COVID-19 period and 10,062 during the COVID-19 period (9026 SARS-CoV-2-negative and 1036 SARS-CoV-2-positive) were analyzed. Patients admitted in the COVID-19 period were significantly older, with a higher prevalence of males. In-hospital AKI incidence was 31.7% during the COVID-19 period (30.5% in SARS-CoV-2-negative patients and 42.2% in SARS-CoV-2-positive ones) as compared to 25.9% during the pre-COVID-19 period (p < 0.0001). In the multivariate analysis, AKI development was independently associated with both SARS-CoV-2 infection and admission period. Moreover, evaluating the pre-admission estimated glomerular filtration rate (eGFR) we found that during the COVID-19 period, there was an increase in AKI stage 2–3 incidence both in patients with pre-admission eGFR < 60 mL/min/1.73 m2 and in those with eGFR ≥ 60 mL/min/1.73 m2 (“de novo” AKI). Similarly, clinical outcomes evaluated as intensive care unit admission, length of hospital stay, and mortality were significantly worse in patients admitted in the COVID-19 period. Additionally, in this case, the mortality was independently correlated with the admission during the COVID-19 period and SARS-CoV-2 infection. In conclusion, we found that during the COVID-19 pandemic, in-hospital AKI epidemiology has changed, not only for patients affected by COVID-19. These modifications underline the necessity to rethink AKI management during health emergencies.

show abstract

“…COVID-19 has greatly affected the patient population with end-stage kidney disease (ESKD). Patients on hemodialysis (HD) are more vulnerable to infection due to treatment with other patients in a confined space and shared transportation ( 1 ) and also at higher risk for adverse outcomes ( 2 ). Identifying patients at risk for adverse outcomes might aid individualized treatment decisions such as the need for hospitalization and more intensive monitoring.…”

Section: Introductionmentioning

confidence: 99%

Modifiable Risk Factors Are Important Predictors of COVID-19-Related Mortality in Patients on Hemodialysis

Kooman

Carioni²,

Kovarova³

et al. 2022

Front. Nephrol.

Self Cite

View full text Add to dashboard Cite

IntroductionPatients with end-stage kidney disease face a higher risk of severe outcomes from SARS-CoV-2 infection. Moreover, it is not well known to what extent potentially modifiable risk factors contribute to mortality risk. In this historical cohort study, we investigated the incidence and risk factors for 30-day mortality among hemodialysis patients with SARS-CoV-2 infection treated in the European Fresenius Medical Care NephroCare network using conventional and machine learning techniques.MethodsWe included adult hemodialysis patients with the first documented SARS-CoV-2 infection between February 1, 2020, and March 31, 2021, registered in the clinical database. The index date for the analysis was the first SARS-CoV-2 suspicion date. Patients were followed for up to 30 days until April 30, 2021. Demographics, comorbidities, and various modifiable risk factors, expressed as continuous parameters and as key performance indicators (KPIs), were considered to tap multiple dimensions including hemodynamic control, nutritional state, and mineral metabolism in the 6 months before the index date. We used logistic regression (LR) and XGBoost models to assess risk factors for 30-day mortality.ResultsWe included 9,211 patients (age 65.4 ± 13.7 years, dialysis vintage 4.2 ± 3.7 years) eligible for the study. The 30-day mortality rate was 20.8%. In LR models, several potentially modifiable factors were associated with higher mortality: body mass index (BMI) 30–40 kg/m2 (OR: 1.28, CI: 1.10–1.50), single-pool Kt/V (OR off-target vs on-target: 1.19, CI: 1.02–1.38), overhydration (OR: 1.15, CI: 1.01–1.32), and both low (<2.5 mg/dl) and high (≥5.5 mg/dl) serum phosphate levels (OR: 1.52, CI: 1.07–2.16 and OR: 1.17, CI: 1.01–1.35). On-line hemodiafiltration was protective in the model using KPIs (OR: 0.86, CI: 0.76–0.97). SHapley Additive exPlanations analysis in XGBoost models shows a high influence on prediction for several modifiable factors as well, including inflammatory parameters, high BMI, and fluid overload. In both LR and XGBoost models, age, gender, and comorbidities were strongly associated with mortality.ConclusionBoth conventional and machine learning techniques showed that KPIs and modifiable risk factors in different dimensions ascertained 6 months before the COVID-19 suspicion date were associated with 30-day COVID-19-related mortality. Our results suggest that adequate dialysis and achieving KPI targets remain of major importance during the COVID-19 pandemic as well.

show abstract

Impact of First Wave COVID-19 Crisis on Dialysis Parameters of COVID-Free Hemodialysis Patients: A NephoCare France Longitudinal Retrospective Cohort Study

Cited by 4 publications

References 16 publications

COVID-19 in dialysis: clinical impact, immune response, prevention, and treatment

COVID-19 in dialysis: clinical impact, immune response, prevention, and treatment

Changes of Acute Kidney Injury Epidemiology during the COVID-19 Pandemic: A Retrospective Cohort Study

Modifiable Risk Factors Are Important Predictors of COVID-19-Related Mortality in Patients on Hemodialysis

Contact Info

Product

Resources

About