Post-COVID-19 outcomes of non-dialysis dependent chronic kidney disease patients: a national, multicenter, controlled study

Abstract

Purpose Coronavirus disease 2019 (COVID-19) has a higher mortality in the presence of chronic kidney disease (CKD). However, there has not been much research in the literature concerning the outcomes of CKD patients in the post-COVID-19 period. We aimed to investigate the outcomes of CKD patients not receiving renal replacement therapy. Methods In this multicenter observational study, we included CKD patients with a GFR < 60 ml/min/1.73 m 2 who survived after confirmed COVID-19. Patients with CKD whose kidney disease was due to diabetic nephropathy, polycystic kidney disease and glomerulonephritis were not included in this study. CKD patients with similar characteristics, who did not have COVID-19 were included as the control group. Results There were 173 patients in the COVID-19 group and 207 patients in the control group. Most patients (72.8%) were treated as inpatient in the COVID-19 group (intensive care unit hospitalization: 16.7%, acute kidney injury: 54.8%, needing dialysis: 7.9%). While there was no significant difference between the baseline creatinine values of the COVID-19 group and the control group (1.86 and 1.9, p = 0.978, respectively), on the 1st month, creatinine values were significantly higher in the COVID-19 group (2.09 and 1.8, respectively, p = 0.028). Respiratory system symptoms were more common in COVID-19 patients compared to the control group in the 1st month and 3rd month follow-ups ( p < 0.001). Mortality at 3 months after the diagnosis of COVID-19 was significantly higher in the COVID-19 group than in the control group (respectively; 5.2% and 1.4%, p :0.037). Similarly, the rate of patients requiring dialysis for COVID-19 was significantly higher than the control group (respectively; 8.1% and 3.4%, p : 0.045). Conclusions In CKD patients, COVID-19 was associated with increased mortality, as well as more deterioration in kidney function and higher need for dialysis in the post-COVID-19 period. These patients also had higher rate of ongoing respiratory symptoms after COVID-19.

Study of Three Years Follow Up Effect of Covid-19 Infection on Patients on Chronic Kidney Disease

“…In the present study, regarding history of ICU admission, MV, incidence of AKI and mortality were significantly different among the studied groups (P < 0.05), being higher in CKD 3 and not observed in CKD 1 suggesting the increased risk with advanced CKD stage. Karadag et al [9] study, in which 173 patients were included, showed that about 65% of patients had ICU admission, 20% had MV, and 2.9% suffered mortality. AKI development occurred in 54.8% of hospitalized patients, whereas 7.9% of patients needed dialysis.…”

Las alteraciones metabólicas y funcionales asociadas a la COVID-19

“…159 En pacientes con diagnóstico previo de enfermedad renal crónica antes de la COVID-19 se ha visto una mayor mortalidad y deterioro de la función renal a los 3 meses de seguimiento en comparación a sus homólogos. 160 Durante el seguimiento a largo plazo también se ha observado que la COVID-19 se asocia a un mayor riesgo de deterioro de la función renal (OR 4,60; IC 95% 2,10-10,08). 161 Un estudio que analizó una cohorte de más de 800.000 pacientes observó que la COVID-19 se asoció a los 6 meses a un mayor riesgo de fracaso renal, enfermedad renal terminal y mortalidad de todas las causas independientemente de la necesidad (HR ajustado 3,37; IC 95% 3,04-3,73) o no de ingreso (HR ajustado 1,15; IC 95% 1,07-1,23) hospitalario.…”