No abstract

Background. The clinical effectiveness of coronavirus disease 2019 (COVID-19) vaccination in kidney transplant (KT) recipients is lower than in the general population. Methods. From April to October 2021, 481 KT recipients with COVID-19, included in the Spanish Society of Nephrology COVID-19 Registry, were analyzed. Data regarding vaccination status and vaccine type were collected, and outcomes of unvaccinated or partially vaccinated patients (n = 130) were compared with fully vaccinated patients (n = 351). Results. Clinical picture was similar and survival analysis showed no differences between groups: 21.7% of fully vaccinated patients and 20.8% of unvaccinated or partially vaccinated died ( P = 0.776). In multivariable analysis, age and pneumonia were independent risk factors for death, whereas vaccination status was not related to mortality. These results remained similar when we excluded patients with partial vaccination, as well as when we analyzed exclusively hospitalized patients. Patients vaccinated with mRNA-1273 (n = 213) showed a significantly lower mortality than those who received the BNT162b2 vaccine (n = 121) (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85; P = 0.010). Conclusions. COVID-19 severity in KT patients has remained high and has not improved despite receiving 2 doses of the mRNA vaccine. The mRNA-1273 vaccine shows higher clinical effectiveness than BNT162b2 in KT recipients with breakthrough infections. Confirmation of these data will require further research taking into account the new variants and the administration of successive vaccine doses.

No abstract

No abstract

Introduction and Aims: Renal dysfunction is an important factor in hospitalized patients' management. The aim of our study was to analyse the prevalence of chronic kidney disease and acute kidney injury in our hospital, length of stay and in-hospital mortality. Methods: Our hospital provides services for 192.290 residents and specialist services to 404.517 from neighbouring areas, with 520 inpatients beds. To improve renal dysfunction detection rates we developed a fully automated, electronic alert system which identifies all cases of reduced glomerular filtration rate according to CKD-EPI formula in patients over 14 years. We established to levels of alert, less than 60 mL/min/1.73m2 and less than 30 mL/min/1.73m2 in patients over 80, based on our national nephrology referral guidelines. Patients admitted to our nephrology department and on dialysis were excluded. Detected patients were studied. Chronic kidney disease (CKD) and acute kidney injury (AKI) was defined according to KDIGO guidelines. Baseline serum creatinine was the lowest level between 0.5-6 months before admission. Length of stay and in-hospital mortality was recorded. Results: Between January and June 2014, 11.022 completed adult patient admission episodes occurred. The number of alerts issued was 1.241 (11.3% of admissions),