Incidence of atherosclerotic CV complications is abnormally high in predialysis CRF patients, suggesting that the uraemic state per se is associated with atherogenesis. As several of the identified clinical and metabolic risk factors for such accidents are potentially remediable by specific therapeutic interventions, prophylactic measures should be initiated long before start of renal replacement therapy.

The aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed.

Elevated baseline serum levels of cardiac troponins were associated with cardiovascular risk factors, history of ischaemic heart disease and left ventricular hypertrophy in asymptomatic chronic haemodialysis patients.

Short-term oral vitamin C supplementation did not modify well-defined oxidative/antioxidative stress and inflammation markers in HD patients. Whether a higher oral dose or the intravenous route can modify these markers remains to be determined.

Rationale & Objective Due to extensive comorbid conditions, COVID-19 has a poor prognosis in people receiving maintenance hemodialysis. In this paper, we describe our experience with 200 maintenance hemodialysis patients in a hemodialysis center that employed universal RT-PCR testing, including 38 COVID-positive patients. Study Design Descriptive observational cohort, including the timeline of patient diagnoses along with contextual events including precautions, testing, screening algorithms, clinical diagnostics and therapy, as well as the clinical course of the COVID infected patients and their final outcomes. Setting & Participants 200 patients within a single hemodialysis center with two dialysis clinics in Paris. Results Among 200 maintenance hemodialysis patients, 38 (19%) were diagnosed with COVID-19; of these, 15 (39.5%) were admitted to the hospital including four who required intensive care unit (ICU) care. There were 8 deaths (21%). The most common symptom was fever, followed by dry cough, fatigue and dyspnea. All COVID-19 patients had lymphopenia and an increase of C-reactive protein. The median time from the onset of respiratory symptoms to ICU admission was one to two days. The duration of non-ICU hospitalization and of ICU stays was 7 and 13 days, respectively. Limitations Retrospective study, single HD center Conclusions Dialysis patients are a highly susceptible population and hemodialysis centers are a high-risk area in a COVID-19 epidemic. "Unexplained" lymphopenia and/or a rise in C-reactive protein should lead physicians to the diagnosis of COVID-19, and should, when possible, be followed by diagnostic testing with universal RT-PCR as well as the reinforcement of contamination barrier measures.

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Evidence indicates that oxidative stress is present in dialysis patients, and is associated with vitamin C deficiency. Limited data are available regarding the effects of vitamin C supplementation on oxidative stress and inflammation markers in these patients. Moreover, there are no data available on plasma polypeptide fingerprints by proteome analysis before and after vitamin C supplementation. Therefore, we analyzed plasma samples from a prospective, randomized, open-labeled trial to assess the effects of oral vitamin C supplementation (250 mg three times per week), to define the plasma polypeptide pattern in hemodialysis patients. Our results reveal that more than 30 polypeptides show significant changes in the dialysis patients in comparison to controls with normal renal function, and that several polypeptides are affected/normalized by oral vitamin C supplementation. These results underline the remarkable potential for proteomics to recognize specific peptide profiles in different pathological situations, which might not be detected by classical methods.

Conclusions: Survival of patients with amyloidosis undergoing dialysis, especially AL type, is probably better than previously reported. However, mortality is higher in AL than AA type, especially in the setting of cardiac involvement.