Kidney disease tied to high death rates in COVID-19 patients

Oct. 20, 2020

A recent study published in Anaesthesia showed COVID-19 patients who have chronic kidney disease (CKD) or develop coronavirus-related kidney injury in the intensive care unit (ICU) face higher odds of death than their otherwise-healthy peers, according to a news report from the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota.

Led by researchers at Imperial College London, the retrospective study involved 372 adult COVID-19 patients in four ICUs in the United Kingdom from March 10 to July 31. Of the 372 patients, 216 (58 percent) had kidney impairment, 22 percent of which was CKD (48 patients) and 78 percent of which developed during hospitalization (168 patients).

In total, 139 of 372 patients (37 percent) died. Of the 156 patients with healthy kidneys, 32 (21 percent) died in the hospital, in contrast with 81 of 168 patients (48 percent) with newly developed kidney injury and 11 of 22 (50 percent) with CKD stage 1 through 4.

Among the other 26 patients who had CKD, 9 of 19 patients (47 percent) with end-stage renal failure (ESRF), who had already required routine outpatient dialysis, died. The death rate was highest in CKD patients who had undergone kidney transplant (6 of 7 [86 percent]).

Death rates rose along with worsening kidney injury classified by Kidney Disease: Improving Global Outcomes (KDIGO) classification; of 157 patients with stage 0 (least) injury, 33 (21 percent) died, compared with those with more serious stages 1 to 3 injury (91/186 [49 percent]). Those who died were more likely to have needed dialysis than survivors (64/139 [46 percent] vs 57/233 [24 percent]). But once dialysis was started, death rates were not significantly different between survivors and non-survivors in patients with new kidney injury (39/82 [48 percent] vs 43/82 [52 percent]) or non–end-stage CKD (8/17 [47 percent] vs 9/17 [53 percent]).

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