ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0782

COVID-19 in CKD Patients: Lessons from 553 CKD Patients with Biopsy-Proven Kidney Disease

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • León Román, Juan, Hospital Vall d'Hebron. Nephrology Department, Barcelona, Spain
  • García-Carro, Clara, Hospital Vall d'Hebron. Nephrology Department, Barcelona, Spain
  • Toapanta, Nestor, Hospital Vall d'Hebron. Nephrology Department, Barcelona, Spain
  • Torres, Irina, Hospital Vall d'Hebron. Nephrology Department, Barcelona, Spain
  • Bury, Roxana, Hospital Vall d'Hebron. Nephrology Department, Barcelona, Spain
  • Baldallo, Cinthia, Hospital Vall d'Hebron. Nephrology Department, Barcelona, Spain
  • Serón, Daniel, Hospital Vall d'Hebron. Nephrology Department, Barcelona, Spain
  • Soler, Maria Jose, Hospital Vall d'Hebron. Nephrology Department, Barcelona, Spain
Background

COVID-19 is a novel coronavirus currently at the centre of a global pandemic, and patients with cardiovascular risk factors such as hypertension and diabetes are at risk of a serious complication such as hospitalization and death. Chronic kidney disease (CKD) increased cardiovascular risk and >90% of CKD patients presented hypertension. The prognosis and lethality of COVID-19 in patients with biopsy-proven kidney disease has not been previously studied.

Methods

Data included patients who underwent a kidney biopsy at the Vall d'Hebron Hospital between January 2013 and February 2020 with diagnostic confirmation and those with high clinical suspicion of SARS-CoV-2 infection during the period from March to May 2020.

Results

Of 553 patients, 39(7%) were diagnosed with SARS-CoV2 infection. The mean age was 63.4±15 years. 48.7% were male, 31 hypertension, 19 diabetic, 12 obese and 18 patients had lung disease. The renal histological diagnosis of glomerulonephritis with extracapillary proliferation in 10.3%, allergic interstitial nephritis in 10.3 %, secondary GSFS in 8.5% and diabetic nephropathy in 10.3%. 4 patients were on hemodialysis and 6 had a kidney transplant. Creatinine before infection was 1.52mg/dL±0,66. 17 patients were under immunosuppressive treatment (14 with prednisone, 8 mycophenolate, 6 tacrolimus, 1 rituximab). 26 patients had confirmation of SARS-CoV2 infection with RT PCR obtained from nasopharyngeal swab. 22 patients required hospital admission [average hospital stay was 16 days±11], of which 4 in the ICU and 6 (15%) died. 15 patients received lopinavir/ritornavir; 23 patients, azithromycin; 20 patients, hydroxychloroquine; 6 patients, tocilizumab; 9 patients, intravenous corticosteroids. 11 patients presented impaired renal function, of which 3 were transplanted and 8 with CKD. CKD patients under RAS blockade had less mortality than patients without RAS blockade treatment (29% vs 0%, p=0.014).

Conclusion

COVID-19 was diagnosed in 7% of our CKD patients with kidney biopsy. The mortality was 15%, lower than the reported in hemodialysis patients. RAS blockade is not exerting a deleterious effect in our CKD patients with COVID-19 infection, suggesting that they should not be withdrawn.