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Kidney Week

Abstract: FR-PO1117

Nationwide In-Hospital Morbidity and Mortality Analysis of COVID-19 Infection in Advanced CKD (aCKD), Dialysis Patients, and Kidney Transplant (KT) Recipients

Session Information

  • COVID-19 - II
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • He, Mingyue, Temple University Hospital, Philadelphia, Pennsylvania, United States
  • Gillespie, Avrum, Temple University Hospital, Philadelphia, Pennsylvania, United States
Background

Individuals with kidney disease, including aCKD, end-stage kidney disease (ESKD), and KT have an increased risk for COVID-19 infection, hospitalization, and mortality compared to those without CKD (CKD-free). The comparative morbidity and mortality among hospitalized COVID-19 patients with aCKD, ESKD, KT, and CKD-free remain uncertain.

Methods

We queried the 2020 Nationwide Inpatient Sample (NIS) database for non-elective adult COVID-19 hospitalizations. Patients were classified into four kidney disease categories: aCKD (stage 3-5, non-dialysis), ESKD (dialysis), KT, and CKD-free. The primary outcome was in-hospital mortality; secondary outcomes included morbidity (septic shock, acute respiratory failure, acute respiratory distress syndrome (ARDS), mechanical ventilation, pressor requirement) and resource utilization (length of hospital stay (LOS), total charges). Outcomes were analyzed with either multivariable logistic or linear regression and adjusted for demographic and comorbidity confounders.

Results

A total of 1,018,915 adults hospitalized for COVID-19 in 2020 were included. Of these, 5.9% had aCKD, 3.9% had ESKD, 0.4% were KT recipients, and 85.0% had no pre-existing CKD. The all-cause in-hospital mortality was 9.7% for CKD-free, 20.5% for aCKD, 19.7% for ESKD, and 12.4% for KT. Results were shown in Figures.

Conclusion

Our study found hospitalized COVID-19 patients with aCKD and ESKD exhibited more comorbidities and higher mortality than those without renal disease. Notably, mortality in KT patients was comparable to the CKD-free group. Thus, managing comorbidities and promoting vaccination is critical in aCKD and ESRD patients.