Department of Nephrology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.
Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul University, Istanbul, Turkey.
Int Urol Nephrol. 2023 Feb;55(2):399-408. doi: 10.1007/s11255-022-03329-8. Epub 2022 Aug 11.
Coronavirus disease 2019 (COVID-19) has a higher mortality in the presence of chronic kidney disease (CKD). However, there has not been much research in the literature concerning the outcomes of CKD patients in the post-COVID-19 period. We aimed to investigate the outcomes of CKD patients not receiving renal replacement therapy.
In this multicenter observational study, we included CKD patients with a GFR < 60 ml/min/1.73 m who survived after confirmed COVID-19. Patients with CKD whose kidney disease was due to diabetic nephropathy, polycystic kidney disease and glomerulonephritis were not included in this study. CKD patients with similar characteristics, who did not have COVID-19 were included as the control group.
There were 173 patients in the COVID-19 group and 207 patients in the control group. Most patients (72.8%) were treated as inpatient in the COVID-19 group (intensive care unit hospitalization: 16.7%, acute kidney injury: 54.8%, needing dialysis: 7.9%). While there was no significant difference between the baseline creatinine values of the COVID-19 group and the control group (1.86 and 1.9, p = 0.978, respectively), on the 1st month, creatinine values were significantly higher in the COVID-19 group (2.09 and 1.8, respectively, p = 0.028). Respiratory system symptoms were more common in COVID-19 patients compared to the control group in the 1st month and 3rd month follow-ups (p < 0.001). Mortality at 3 months after the diagnosis of COVID-19 was significantly higher in the COVID-19 group than in the control group (respectively; 5.2% and 1.4%, p:0.037). Similarly, the rate of patients requiring dialysis for COVID-19 was significantly higher than the control group (respectively; 8.1% and 3.4%, p: 0.045).
In CKD patients, COVID-19 was associated with increased mortality, as well as more deterioration in kidney function and higher need for dialysis in the post-COVID-19 period. These patients also had higher rate of ongoing respiratory symptoms after COVID-19.
新冠肺炎（COVID-19）在合并慢性肾脏病（CKD）患者中死亡率更高。然而，文献中对于 COVID-19 后 CKD 患者结局的研究并不多。我们旨在研究未接受肾脏替代治疗的 CKD 患者的结局。
在这项多中心观察性研究中，我们纳入了 COVID-19 后存活且肾小球滤过率（GFR）<60 ml/min/1.73 m2 的 CKD 患者。本研究未纳入因糖尿病肾病、多囊肾病和肾小球肾炎导致 CKD 的患者。我们纳入了具有相似特征且未感染 COVID-19 的 CKD 患者作为对照组。
COVID-19 组有 173 例患者，对照组有 207 例患者。COVID-19 组大多数患者（72.8%）为住院治疗（重症监护病房住院：16.7%，急性肾损伤：54.8%，需要透析：7.9%）。COVID-19 组和对照组的基线血肌酐值无显著差异（分别为 1.86 和 1.9，p=0.978），但在第 1 个月时，COVID-19 组的血肌酐值显著升高（分别为 2.09 和 1.8，p=0.028）。与对照组相比，COVID-19 患者在第 1 个月和第 3 个月的随访中呼吸系统症状更常见（p<0.001）。COVID-19 组患者在 COVID-19 确诊后 3 个月的死亡率明显高于对照组（分别为 5.2%和 1.4%，p=0.037）。同样，COVID-19 患者需要透析的比例也明显高于对照组（分别为 8.1%和 3.4%，p=0.045）。
在 CKD 患者中，COVID-19 与 COVID-19 后死亡率增加、肾功能恶化以及需要透析的几率增加相关。这些患者在 COVID-19 后仍有更高的持续呼吸系统症状发生率。
