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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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COVID-19-related mortality in kidney transplant and haemodialysis patients: a comparative, prospective registry-based

Eric Goffin1, Alexandre Candellier1,2, Priya Vart3

  • 1Department of Nephrology, Cliniques Universitaires Saint-Luc, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|June 16, 2021
PubMed

Insights

Kidney transplant recipients face a higher risk of severe COVID-19 compared to haemodialysis patients. This highlights the need for tailored infection control strategies for transplant recipients during the pandemic.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Transplantation Immunology

Background:

  • The COVID-19 pandemic posed significant risks to patients undergoing kidney replacement therapy (KRT).
  • Haemodialysis (HD) patients and kidney transplant (KT) recipients were particularly vulnerable to severe outcomes from SARS-CoV-2 infection.
  • Concerns arose regarding the optimal KRT strategy during the pandemic.

Purpose of the Study:

  • To investigate the association between the type of KRT and COVID-19 severity.
  • To adjust for individual patient characteristics when comparing COVID-19 outcomes in KT recipients and HD patients.

Main Methods:

  • Data from 1670 patients (496 KT, 1174 HD) diagnosed with COVID-19 between February and December 2020 were analyzed.
  • European Renal Association COVID-19 Database was utilized.
  • Adjusted Cox regression models assessed 28-day mortality risk, accounting for age, sex, frailty, and comorbidities.

Main Results:

  • Unadjusted analysis showed lower mortality in KT recipients (HR 0.67).
  • However, adjusted analysis revealed a significantly higher 28-day mortality risk in KT recipients (HR 1.78) compared to HD patients.
  • This increased risk was particularly pronounced in the first year post-transplant and for other severe outcomes like ICU admission.

Conclusions:

  • Kidney transplant recipients experienced a more severe course of COVID-19 compared to haemodialysis patients.
  • Specific infection mitigation strategies are crucial for KT recipients.
  • These findings underscore the importance of personalized risk assessment and management in KRT patients during infectious disease outbreaks.
Abstract

Keywords:
COVID-19dialysiskidneymortalitytransplantation

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