Chronic kidney disease and acute kidney injury in the COVID-19 Spanish outbreak

Pórtoles, José; Marqués, María; López–Sánchez, Paula; Valdenebro, María; Múñez, Elena; Serrano, María Luisa Madueño; Malo, Rosa; García, Estefanya; Cuervas, V.

doi:10.1093/ndt/gfaa189

Cited by 99 publications

(102 citation statements)

References 24 publications

(29 reference statements)

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“…The percentage of patients with CKD in our study does not differ much from that observed in other cohorts of patients with COVID-19 [ 11 ]. This condition, in the present study, confers a higher risk of mortality, as already shown [ 12 , 13 ]. Indeed, from 11.6% (present study) to 16.2% [ 11 ] of patients with COVID- 19 show CKD and the lower the estimated glomerular filtrate rate (eGFR), the higher the risk of mortality (eGFR 30–59 mL/min/1.73 m 2 : HR 3.01; eGFR < 30 mL/min/1.73 m 2 : HR 6.61) [ 12 ].…”

Section: Discussionsupporting

confidence: 89%

Mortality and Transfusion Requirements in COVID-19 Hospitalized Italian Patients According to Severity of the Disease

Pesavento

Tiscia

Laurenzo

et al. 2021

JCM

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There is paucity of data on the transfusion need and its impact on the overall mortality in patients with COVID-19. We explored mortality in hospitalized patients with COVID-19 who required transfusions. Information on clinical variables and in-hospital mortality were obtained from medical records of 422 patients admitted to medical wards or the Intensive Care Unit (ICU). In-hospital mortality occurred in 147 (34.8%) patients, 94 (63.9%) of whom were admitted to the ICU. The median fatalities age was 77 years (IQR 14). Overall, 100 patients (60 males) received transfusion during hospitalization. The overall mortality was significantly and independently associated with age, ICU admission, Chronic Kidney Disease (CKD), and the number of transfused Red Blood Cell (RBC) units. Specifically, CKD was associated with mortality in patients admitted to medical wards, whereas the number of transfused RBC units predicted mortality in those admitted to the ICU. Transfusion strongly interacted with the admission to ICU (OR: 9.9; 95% CI: 2.5–40.0). In patients with COVID-19, age is one of the strongest risk factors in predicting mortality independently of the disease’s severity. CKD confers a higher risk of mortality in patients admitted to medical wards. In those admitted to the ICU, the more RBC units are transfused, the more mortality increases.

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Section: Discussionsupporting

confidence: 89%

Mortality and Transfusion Requirements in COVID-19 Hospitalized Italian Patients According to Severity of the Disease

Pesavento

Tiscia

Laurenzo

et al. 2021

JCM

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“…As in previous studies, diabetes was associated with an increased risk of hospitalisation and death [ 44 ]. Chronic renal disease was not associated with ICU admission, though it was the comorbidity with the highest risk of death and its association with mortality has been highlighted elsewhere [ 45 ]. Cardiovascular disease was a consistent risk factor across all severe outcomes [ 46 ], even though it was not the strongest one.…”

Section: Discussionmentioning

confidence: 99%

The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020

2020

Eurosurveillance

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Background The first wave of the coronavirus disease (COVID-19) pandemic spread rapidly in Spain, one of Europe’s most affected countries. A national lockdown was implemented on 15 March 2020. Aim To describe reported cases and the impact of national lockdown, and to identify disease severity risk factors. Methods National surveillance data were used to describe PCR-confirmed cases as at 27 April 2020. We compared case characteristics by severity categories (hospitalisation, admission to intensive care unit (ICU), death) and identified severity risk factors using multivariable regression. Results The epidemic peaked on 20 March. Of 218,652 COVID-19 cases, 45.4% were hospitalised, 4.6% were admitted to ICU and 11.9% died. Among those who died, 94.8% had at least one underlying disease. Healthcare workers (HCWs) represented 22.9% of cases. Males were more likely to have severe outcomes than females. Cardiovascular disease was a consistent risk factor. Patients with pneumonia had higher odds of hospitalisation (odds ratio (OR): 26.63; 95% confidence interval (CI): 25.03–28.33). The strongest predictor of death was age ≥ 80 years (OR: 28.4; 95% CI: 19.85–40.78). Among underlying diseases, chronic renal disease had highest odds of death (OR: 1.47; 95% CI: 1.29–1.68). Conclusions COVID-19 case numbers began declining 6 days after the national lockdown. The first wave of the COVID-19 pandemic in Spain had a severe impact on elderly people. Patients with cardiovascular or renal conditions were at higher risk for severe outcomes. A high proportion of cases were HCWs. Enhanced surveillance and control measures in these subgroups are crucial during future COVID-19 waves.

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“… Rubin [ 24 ] a 71 (I) 23% 61.2 4 (6%) 21 (30%) 57 (80%) Stage 1: 28% Stage 2: 28% Stage 3: 24% 10 (14%) 55 (71%) 4 (5.6%) At day 21, 64% of patients had recovered from AKI, and 11% were RRT dependent. Portolés [ 25 ] 1603 (G + I) 40 64 144 (9%) 561 (35%) 336 (21%) 17 (1%) NR 197 (12.3%) A prospective cohort study showing in-hospital AKI associated with high mortality ISARIC [ 26 ] 20,133 (I) 40.1% 72.9 2830 (16.2%) 5469 (31%) NR NR 618 (37%) NR Higher proportion of patients had CKD, with a multivariate HR of 1.28 for death. United States Study N (setting) Female (%) Median age, years History of CKD, n (%) History of CVD, n (%) AKI Incidence, n (%) RRT, n (%) Mechanical Ventilation, n (%) Mortality, n (%) Salient Findings Arentz [ 27 ] a 21 (I) 48 70 10 (47.6%) 9 (42.9%) 4 (19%) NR 15 (71%) 11 (52.4%) 2 patients with ESKD.…”

Section: Main Textmentioning

confidence: 99%

The COVID-19 nephrology compendium: AKI, CKD, ESKD and transplantation

et al. 2020

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The pandemic of coronavirus disease 2019 (CoVID-19) has been an unprecedented period. The disease afflicts multiple organ systems, with acute kidney injury (AKI) a major complication in seriously ill patients. The incidence of AKI in patients with CoVID-19 is variable across numerous international studies, but the high incidence of AKI and its associated worse outcomes in the critical care setting are a consistent finding. A multitude of patterns and mechanisms of AKI have been elucidated, and novel strategies to address shortage of renal replacement therapy equipment have been implemented. The disease also has had consequences on longitudinal management of patients with chronic kidney disease and end stage kidney disease. Kidney transplant recipients may be especially susceptible to CoVID-19 as a result of immunosuppression, with preliminary studies demonstrating high mortality rates. Increased surveillance of disease with low threshold for testing and adjustment of immunosuppression regimen during acute periods of illness have been recommended.

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Chronic kidney disease and acute kidney injury in the COVID-19 Spanish outbreak

Cited by 99 publications

References 24 publications

Mortality and Transfusion Requirements in COVID-19 Hospitalized Italian Patients According to Severity of the Disease

Mortality and Transfusion Requirements in COVID-19 Hospitalized Italian Patients According to Severity of the Disease

The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020

The COVID-19 nephrology compendium: AKI, CKD, ESKD and transplantation

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