Characteristics and outcomes of hospitalised older patients with chronic kidney disease and COVID‐19: A multicenter nationwide controlled study

Öztürk, Savaş; Turgutalp, Kenan; Arıcı, Mustafa; Gök, Mahmut; İslam, Mahmud; Altiparmak, Mehmet Rıza; Aydın, Zeki; Döner, Barış; Eren, Necmi; Şengül, Erkan; Karadağ, Serhat; Özler, Tuba Elif; Dheir, Hamad; Pembegül, İrem; Taymez, Dilek Güven; Şahin, Garip; Bakırdöğen, Serkan; Dölarslan, Mürşide Esra; Soypaçacı, Zeki; Hür, Ender; Kara, Ekrem; Baştürk, Taner; Öğütmen, Melike Betül; Görgülü, Numan; Şahi̇n, İdris; Aylı, Mehmet Deniz; Tuglular, Z. Serhan; Şahin, Gülizar Manga; Tokgöz, Bülent; Tonbul, Halil Zeki; Yıldız, Alaattin; Sezer, Sıren; Odabaş, Ali Rıza; Ateş, Kenan

doi:10.1111/ijcp.14428

Cited by 14 publications

(12 citation statements)

References 38 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The presence of kidney disease is a risk factor for poor outcomes of severe infections such as COVID-19 (32)(33)(34)(35)(36), and infections are the second common cause of death in patients with CKD (37)(38)(39). This has been attributed to secondary immunodeficiency (SIDKD) to which many of the consequences of kidney disease contribute (8).…”

Section: Discussionmentioning

confidence: 99%

Biological drugs for systemic lupus erythematosus or active lupus nephritis and rates of infectious complications. Evidence from large clinical trials

Steiger

Ehreiser²,

Anders³

et al. 2022

Front. Immunol.

View full text Add to dashboard Cite

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease that frequently affects the kidneys, known as lupus nephritis (LN). Such patients are treated with antimalarials, corticosteroids or immunosuppressive drugs, and more recently, target-specific biological drugs. Although efficacy of these therapies improved SLE-related outcomes, SLE remains associated with higher rates of infections. Here, we performed a comprehensive systemic review of infectious complications in clinical trials covering drug interventions for SLE or specifically for active LN. Our search in 15 online registries yielded a total of 1477 studies of which 14 matched our prespecified criteria. These covered the biological drugs anifrolumab, belimumab, and rituximab that were tested in patients with non-renal SLE and active LN.The available safety data from the SLE trials indicated that infectious complications such as herpes zoster, upper respiratory tract infection, nasopharyngitis, bronchitis, and urinary tract infection in patients receiving placebo were quite prevalent especially in the EXPLORER (rituximab) trial. Infections occurred mostly during the first year of LN therapy. Serious adverse events and infectious complications occurred more frequently in placebo-treated patients with active LN, especially in the BLISS-LN (belimumab) and LUNAR (rituximab) trials. Anifrolumab and rituximab increased the number of clinically relevant episodes of herpes zoster compared to belimumab in patients with active LN. Anifrolumab displayed a similar trend for influenza infections, which is consistent with the specific mechanisms-of-action of anifrolumab; highlighting drug-specific effects on infectious complications. In addition, standard-of-care therapy, e.g., MMF and immunosuppressants, as well as a longer SLE duration may also affect the incidence of serious adverse events and certain infectious complications in SLE patients with active LN.Infectious complications are common in SLE but even more common in patients with active LN, especially herpes zoster is strongly associated with active LN and anifrolumab therapy (OR 2.8, 95% CI 1.18 to 6.66, p = 0.018). Immunotherapy seems to impose unspecific and specific risks for infections. The latter may imply specific precautions such as preemptive vaccination and individual risk-benefit assessments.

show abstract

Section: Discussionmentioning

confidence: 99%

Biological drugs for systemic lupus erythematosus or active lupus nephritis and rates of infectious complications. Evidence from large clinical trials

Steiger

Ehreiser²,

Anders³

et al. 2022

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…Patients presenting with pre-existing kidney conditions, such as chronic kidney disease (CKD), including both end-stage kidney disease (ESKD) and pre-dialysis CKD, are also at greater risk for poor outcomes from COVID-19. Baseline kidney disease has been consistently found to be an independent risk factor for severe disease or mortality from COVID-19, even when adjusting for confounding risk factors, such as underlying diabetes, hypertension, and cardiovascular disease [18,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]. Despite the clear connection between baseline kidney function and COVID-19 severity, far fewer data have been published to elucidate the effect of survival from COVID-19 on subsequent long-term kidney function, but four recent analyses of large datasets suggest a link [55][56][57][58].…”

Section: Relationship Between Covid-19 Pre-existing Ckd and Risk Of F...mentioning

confidence: 99%

Kidney Injury in COVID-19: Epidemiology, Molecular Mechanisms and Potential Therapeutic Targets

Teixeira

Barone

Zahedi

et al. 2022

IJMS

View full text Add to dashboard Cite

As of December 2021, SARS-CoV-2 had caused over 250 million infections and 5 million deaths worldwide. Furthermore, despite the development of highly effective vaccines, novel variants of SARS-CoV-2 continue to sustain the pandemic, and the search for effective therapies for COVID-19 remains as urgent as ever. Though the primary manifestation of COVID-19 is pneumonia, the disease can affect multiple organs, including the kidneys, with acute kidney injury (AKI) being among the most common extrapulmonary manifestations of severe COVID-19. In this article, we start by reflecting on the epidemiology of kidney disease in COVID-19, which overwhelmingly demonstrates that AKI is common in COVID-19 and is strongly associated with poor outcomes. We also present emerging data showing that COVID-19 may result in long-term renal impairment and delve into the ongoing debate about whether AKI in COVID-19 is mediated by direct viral injury. Next, we focus on the molecular pathogenesis of SARS-CoV-2 infection by both reviewing previously published data and presenting some novel data on the mechanisms of cellular viral entry. Finally, we relate these molecular mechanisms to a series of therapies currently under investigation and propose additional novel therapeutic targets for COVID-19.

show abstract

“…A large study from Turkey analyzed 1,210 patients with COVID-19 and found that intensive care unit (ICU) admission and the mortality rate were higher in patients with CKD and HD patients compared to those without kidney disease [ 9 ]. Another study from Turkey analyzed 879 CKD and control patients, 68.8% of them were more than 65 years of age and found out that severe-critical disease, ICU admission, and in-hospital mortality were found to be more frequent in the older group regardless of demographic parameters, comorbidities, clinical, and laboratory data on presentation [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Survival Results of Peritoneal Dialysis Patients Suffering from COVID-19 in Turkey: A Multicenter National Study

Gürsu

Öztürk

Arıcı

et al. 2022

Kidney Blood Press Res

Self Cite

View full text Add to dashboard Cite

Background: We aimed to study the characteristics of peritoneal dialysis (PD) patients with Coronavirus disease-19 (COVID-19), determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. Methods: In this multicenter national study, we included PD patients with confirmed COVID-19 from 27 centers. The baseline demographic, clinical, laboratory, and radiological data and outcomes at the end of the first month were recorded. Results: We enrolled 142 COVID-19 patients (median age:52 years). 58.2% of patients had mild disease at diagnosis. Lung involvement was detected in 60.8% of patients. 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for four (2.8%) patients. Persisting pulmonary symptoms (n=27), lower respiratory system infection (n=12), rehospitalization for any reason (n=24), malnutrition (n=6), hypervolemia (n=13), peritonitis (n=7), ultrafiltration failure (n=7) and in PD modality change (n=8) were reported in survivors. 26 patients (18.31%) died in the first month of diagnosis. The non-survivor group was older, comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement, and pleural effusion were more frequent among non-survivors. Age (OR:1.102; 95%CI: 1.032-1.117; p: 0.004), moderate-severe clinical disease at presentation (OR:26.825; 95%CI: 4.578-157.172; p<0.001) and baseline CRP (OR:1.008; 95%CI; 1.000-1.016; p:0.040) were associated with first-month mortality in multivariate analysis. Conclusions: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19, and baseline CRP level are the independent parameters associated with mortality.

show abstract

Characteristics and outcomes of hospitalised older patients with chronic kidney disease and COVID‐19: A multicenter nationwide controlled study

Cited by 14 publications

References 38 publications

Biological drugs for systemic lupus erythematosus or active lupus nephritis and rates of infectious complications. Evidence from large clinical trials

Biological drugs for systemic lupus erythematosus or active lupus nephritis and rates of infectious complications. Evidence from large clinical trials

Kidney Injury in COVID-19: Epidemiology, Molecular Mechanisms and Potential Therapeutic Targets

Characteristics and Survival Results of Peritoneal Dialysis Patients Suffering from COVID-19 in Turkey: A Multicenter National Study

Contact Info

Product

Resources

About