Abstract: PO0779
COVID-19 in CKD: Retrospective, Propensity Score-Matched Cohort Study
Session Information
- COVID-19: CKD and Transplant Patients
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
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, %) | Favipiravir | 26 (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 patients | 11 (19.6%) | 16 (28.6%) | 0.269 |
Abbreviations; CKD, chronic kidney disease; CRP, C-reactive protein.