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Abstract: PO0779

COVID-19 in CKD: Retrospective, Propensity Score-Matched Cohort Study

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Dirim, Ahmet Burak, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Demir, Erol, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Yadigar, Serap, Dr Lufti Kirdar Kartal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
  • Safak, Seda, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Parmaks?z, Ergün, Dr Lufti Kirdar Kartal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
  • Guller, Nurana, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Medetalibeyoglu, Alpay, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Oto, Ozgur Akin, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Aydin Bahat, Kubra, Dr Lufti Kirdar Kartal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
  • Oruc, Meric, Dr Lufti Kirdar Kartal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
  • Basaran, Seniha, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Orhun, Günseli, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Yazici, Halil, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
  • Turkmen, Aydin, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
Background

The prognostic factors for COVID-19 in patients with chronic kidney disease (CKD) are uncertain. We conducted a propensity score-matched study to compare clinical and prognostic features between hospitalized COVID-19 patients with and without CKD.

Methods

Patients with estimated creatinine clearance below 60 ml/min/1.73 m2 for more than three months, were included in the CKD group. Fifty-six patients and the propensity score-matched fifty-six control patients were followed-up at least 15 days or until death after diagnosis of COVID-19. All demographic data and diagnostic and therapeutic methods were evaluated. The endpoints were all-cause mortality and acute kidney injury (AKI).

Results

Patient and control groups were reviewed retrospectively over a median follow-up of 44 days (IQR, 36-52 days) after diagnosis of COVID-19. Patients in the CKD group had higher intensive care unit follow-up and mortality rates than the other group, but these results did not reach statistical significance (16 [28.6%] vs. 19 [33.9%]; p=0.54 and 11 [19.6%] vs. 16 [28.6%], p=0.269, respectively). The frequency of AKI was significantly higher in predialysis patients with CKD compared to the other group (8 [14.3%] vs. 5 [45.5%]; p<0.001), but there was no significant difference between the groups in terms of cytokine release syndrome and respiratory failure (13 [23.2%] vs. 8 [14.2%]; p=0.226, 25 [44.6%] vs. 22 [39.3%], p=0.566, respectively). Multivariate logistic regression analysis revealed that respiratory failure (39.283 [95% CI, 7.296 to 211.519; P<0.001] and AKI (10.961 [95% CI, 1.688 to 71.186; P=0.012] were independent risk factors for the mortality.

Conclusion

The prognosis of COVID-19 in patients with CKD is worse than non-uremic patients. Also, AKI and respiratory failure are independent risk factors for mortality.

Table 1. The laboratory results, treatment regimen, and outcomes of the patients
  Control group
(n=56)
Patients
with CKD (n=56)
p-value
Laboratory results
at admission
(Median-IQR 25-75)
Lymphocyte count (/mm3)
Serum CRP levels (mg/L)
Serum Ferritin levels (ng/ml)
1150 (758-1478)
39 (17-93)
247 (149-580)
940 (520-1355)
55 (18-154)
731 (723-2860)
0.055
0.027
<0.0001
Anti-viral treatment (N, %)Favipiravir26 (46.4%)15 (27.3%)0.037
Anti-cytokine agents (N, %)Tocilizumab
Anakinra
Tocilizumab+Anakinra
5 (8.9%)
3 (5.4%)
5 (8.9%)
1 (1.8%)
4 (7.3%)
3 (5.5%)
0.324
Outcomes (N%)Number of died patients11 (19.6%)16 (28.6%)0.269

Abbreviations; CKD, chronic kidney disease; CRP, C-reactive protein.