COVID-19 in chronic kidney disease: a retrospective, propensity score-matched cohort study

Int Urol Nephrol. 2021 Oct;53(10):2117-2125. doi: 10.1007/s11255-021-02783-0. Epub 2021 Feb 6.

Abstract

Background: The prognostic factors for COVID-19 in patients with chronic kidney disease (CKD) are uncertain. We conducted a study to compare clinical and prognostic features between hospitalized COVID-19 patients with and without CKD.

Methods: Fifty-six patients with stage 3-5 CKD and propensity score-matched fifty-six patients without CKD were included in the study. Patients were followed-up at least fifteen days or until death after COVID-19 diagnosis. The endpoints were death from all causes, development of acute kidney injury (AKI) or cytokine release syndrome or respiratory failure, or admission to the intensive care unit (ICU).

Results: All patients were reviewed retrospectively over a median follow-up of 44 days (IQR, 36-52) after diagnosis of COVID-19. Patients with CKD had higher intensive care unit admission and mortality rates than the patients without CKD, but these results did not reach statistical significance (16 vs. 19; p = 0.54 and 11 vs. 16, p = 0.269, respectively). The frequency of AKI development was significantly higher in predialysis patients with CKD compared to the other group (8 vs. 5; p < 0.001), but there was no significant difference between the groups in terms of cytokine release syndrome (13 vs. 8; p = 0.226), follow-up in the ICU (19 vs. 16; p = 0.541), and respiratory failure (25 vs. 22, p = 0.566). Multivariate logistic regression analysis revealed that respiratory failure and AKI were independent risk factors for mortality.

Conclusion: The mortality rates of COVID-19 patients with CKD had higher than COVID-19 patients without CKD. Also, AKI and respiratory failure were independently related to mortality.

Keywords: Acute kidney injury; COVID-19; Chronic kidney disease; End-stage kidney disease.

MeSH terms

  • Acute Kidney Injury / epidemiology
  • Adult
  • Aged
  • COVID-19 / complications*
  • COVID-19 / epidemiology*
  • COVID-19 / therapy
  • Critical Care
  • Cytokine Release Syndrome / epidemiology
  • Female
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Propensity Score
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / mortality
  • Renal Insufficiency, Chronic / therapy
  • Respiratory Insufficiency / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Survival Rate