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Kidney Week

Abstract: SA-PO648

Peritoneal Dialysis Offers Similar Outcomes to Hemodialysis in Hospitalized Patients Admitted with COVID-19

Session Information

  • Home Dialysis - II
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Painter, David, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Hu, Susie L., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
  • Raker, Christina A., Rhode Island Hospital, Providence, Rhode Island, United States
Background

The COVID-19 pandemic has resulted in hundreds of millions of infections and more than 6 million deaths worldwide. Maintenance dialysis patients were at uniquely high risk for both acquisition and morbidity and mortality related to COVID-19. Our studies objective is to assess outcomes by dialysis modality using a large, population based database in the United states. Specifically, we sought to quantify the effects of dialysis modality on hospital mortality, length of stay, and hospital charges. This work will be useful in public health planning and resource utilization for a future respiratory pandemic.

Methods

We retrospectively identified patients in the 2020 National Inpatient Sample with primary diagnosis code of COVID-19 and ICD-10-PCS codes for hemodialysis or peritoneal dialysis. Descriptive statistics were performed on demographic, comorbidities, hospital, and outcome variables. Primary outcomes were Mortality and secondary outcomes were Length of Stay and Hospital Charges. Linear and Logistic Regression with survey weights were used to develop models accounting for demographic, clinical, and hospital factors.

Results

A total of 54,580 COVID-19 patients with ESKD were identified in the NIS database, of which 1,730 patients were on PD and 52,850 patients were on HD. After adjusting for demographic and clinical factors, there was no significant difference in in-hospital mortality between PD and HD patients (adjusted odds ratio [aOR] = 1.13, 95% confidence interval [CI]: .85-1.49, p=.389). Similarly, LOS (adjusted mean difference (aMD)= -.344, 95% CI: -1.52-.84, p=.569) and hospital charges (aMD = -4868.31, 95% CI: -27562.54-17825.92, p=.674) did not significantly differ between the two groups.

Conclusion

This study provides evidence that COVID-19 infection requiring hospitalization in PD patients is associated with similar outcomes compared to HD patients. PD patients had similar in-hospital mortality rates, lengths of stay, and hospital charges. These findings suggest that both PD and HD patients with ESKD are equally vulnerable to the morbidity and mortality COVID-19, although PD patients are able to better shield from acquiring the virus. Further research is needed to explore additional factors that may influence outcomes and to guide clinical decision-making for ESKD patients during the COVID-19 pandemic.

Funding

  • Clinical Revenue Support