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Chronic kidney disease predicts poor outcomes of COVID-19 patients
Mahmut Gok1, Hakki Cetinkaya2, Tugba Kandemir3
1Nephrology Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey. mahmut_gok@yahoo.com.tr.
Insights
Patients with chronic kidney disease (CKD) stage 3-5 hospitalized with COVID-19 face a significantly higher risk of in-hospital mortality. Early monitoring for those with reduced kidney function is crucial for better outcomes.
Area of Science:
- Nephrology
- Infectious Diseases
- Critical Care Medicine
Background:
- The COVID-19 pandemic highlighted the impact of comorbidities on disease severity and mortality.
- Chronic kidney disease (CKD) is a significant comorbidity affecting patient outcomes in various infections.
Purpose of the Study:
- To investigate the association between the stage of chronic kidney disease (CKD) and the severity of COVID-19 infection.
- To determine if CKD is an independent risk factor for mortality in COVID-19 patients.
Main Methods:
- A cohort of 609 hospitalized COVID-19 patients was analyzed.
- Patients were categorized into two groups based on CKD stage (Stage 1-2 vs. Stage 3-5).
- Data on laboratory parameters, comorbidities, and mortality were collected and analyzed.
Main Results:
- Patients with CKD stage 3-5 exhibited significantly higher rates of comorbidities like hypertension and diabetes mellitus.
- Acute kidney injury (AKI) was prevalent in the advanced CKD group and strongly associated with mortality.
- Multivariate analysis identified advanced CKD (stage 3-5), AKI, male gender, hypertension, diabetes mellitus, and malignancy as independent predictors of increased mortality.
Conclusions:
- Advanced CKD (stage 3-5) upon admission is a significant risk factor for in-hospital mortality in COVID-19 patients.
- Close monitoring and management are recommended for COVID-19 patients with reduced glomerular filtration rate (GFR).
Purpose:
The recent outbreak of COVID-19 rapidly spread worldwide. Comorbid diseases are determinants of the severity of COVID-19 infection and mortality. The aim of this study was to explore the potential association between chronic kidney disease (CKD) and the severity of COVID-19 infection.
Methods:
The study included 609 consecutive adult patients (male: 54.52%, mean age: 59.23 ± 15.55 years) hospitalized with the diagnosis of COVID-19 in a tertiary level hospital. Data were collected from the electronic health records of the hospital. The patients were separated into two groups: Group I included COVID-19-positive patients with CKD stage 1-2, and Group II included COVID-19-positive with CKD stage 3-5. The relationships were examined between CKD stage, laboratory parameters and mortality.
Results:
Significant differences were determined between the groups in respect of the inflammation parameters and the parameters used in prognosis. In Group II, statistically significantly higher rates were determined of comorbid diseases [hypertension (p < 0.001) and diabetes mellitus (p < 0.001), acute kidney injury (AKI), which was found to be associated with mortality (p < 0.001), and mortality (p < 0.001)]. In multivariate regression analysis, CKD stage 3-5, AKI, male gender, hypertension, DM and malignancy were found to be significant independent variables increasing mortality.
Conclusion:
The prevelance of CKD stage 3-5 on admission is associated with a high risk of in-hospital mortality in patients with COVID-19. Close follow-up can be recommended for patients with a reduced glomerular filtration rate (GFR).
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