Aziz Fahad, Mandelbrot Didier, Singh Tripti, Parajuli Sandesh, Garg Neetika, Mohamed Maha, Astor Brad C, Djamali Arjang
Division of Nephrology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, the University of Wisconsin Hospital and Clinics, Madison, WI.
Division of Nephrology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, the University of Wisconsin Hospital and Clinics, Madison, WI.
Transplant Proc. 2020 Nov;52(9):2659-2662. doi: 10.1016/j.transproceed.2020.07.002. Epub 2020 Jul 13.
Kidney transplant recipients (KTR) present unique characteristics, including disease vintage, immunosuppression, and single functioning kidneys. We conducted preliminary analyses to assess the impact of coronavirus disease 2019 (COVID-19) on outcomes in KTR compared to nontransplant patients.
We evaluated published information in peer-reviewed journals between January 1, 2020, and April 24, 2020, with available data on acute kidney injury (AKI), renal replacement therapy (RRT), intensive care unit (ICU) stay, and death and compared clinical outcomes in KTR vs nontransplant recipients with COVID-19.
A total of 19 published articles were identified, including a total of 88 KTR and 5342 nontransplant patients. The sample size varied between 2 and 2634. Mean age was 58.6 years vs 58.9 years in KTR vs nontransplant patients. Patient-level incidence of AKI (27.5% vs 13.3%, P < .001), RRT (15.4% vs 3.3%, P < .001), ICU stay (34.1% vs 15.1%, P < .001), and death (22.7% vs 16.2%, P = .10) was higher in KTR, representing relative risks of 2.06 (1.44, 2.96), 4.72 (2.62, 8.51), 2.25 (1.67, 3.03), and 1.41 (0.95, 2.08), respectively.
Early results suggest that the KTR are at significantly higher risk of AKI, RRT, and ICU stay from SARS-CoV-19 infection compared to the general population. The risk of death may not be significantly different.
肾移植受者(KTR)具有独特的特征,包括疾病病程、免疫抑制以及单肾发挥功能。我们进行了初步分析,以评估2019冠状病毒病(COVID-19)与非移植患者相比对肾移植受者预后的影响。
我们评估了2020年1月1日至2020年4月24日期间同行评审期刊上发表的信息,这些信息包含急性肾损伤(AKI)、肾脏替代治疗(RRT)、重症监护病房(ICU)住院时间以及死亡情况的可用数据,并比较了感染COVID-19的肾移植受者与非移植受者的临床结局。
共识别出19篇已发表文章,包括88例肾移植受者和5342例非移植患者。样本量在2至2634之间。肾移植受者的平均年龄为58.6岁,非移植患者为58.9岁。肾移植受者中AKI(27.5%对13.3%,P <.001)、RRT(15.4%对3.3%,P <.001)、ICU住院(34.1%对15.1%,P <.001)和死亡(22.7%对16.2%,P =.10)的患者水平发生率更高,相对风险分别为2.06(1.44,2.96)、4.72(2.62,8.51)、2.25(1.67,3.03)和1.41(0.95,2.08)。
早期结果表明,与普通人群相比,肾移植受者因感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)而发生AKI、RRT和入住ICU的风险显著更高。死亡风险可能无显著差异。