Kolovos Peter, Davies Christopher E, Kholmurodova Feruza, Irish Georgina, Kulkarni Hemant, Polkinghorne Kevan R, Dendle Claire, Pilmore Andrew, Potter Daniela, Roberts Matthew, Thomas Subi, Kotwal Sradha, Menahem Solomon
Renal Medicine, Nepean Hospital, Penrith, New South Wales, Australia.
South Australian Health and Medical Research Institute, Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia.
Intern Med J. 2025 Apr;55(4):622-629. doi: 10.1111/imj.16628. Epub 2025 Jan 11.
The COVID-19 pandemic impacted greatest among patients with pre-existing chronic health conditions, including chronic kidney disease. This retrospective cohort study aimed to investigate the 30-day mortality of patients receiving kidney replacement therapy (KRT) after infection with COVID-19, living in Australia and New Zealand between 2020 and 2022, including patients on haemodialysis (HD), peritoneal dialysis (PD) and renal transplant (KT) recipients.
This is a retrospective cohort study using data from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA). Patients were included if they tested positive for COVID-19 infection while receiving KRT between the first reported infection in January 2020 and the end of November 2022. Multivariable logistic regression was used to assess the relationship between KRT modality and 30-day mortality following COVID-19 infection, with all potential confounders included.
A total of 9828 patients requiring KRT tested positive for COVID-19 within Australia and New Zealand between 2020 and 2022. The crude mortality rate by KRT modality was 3.0% for HD, 3.8% for PD and 2.4% for KT. In the adjusted model, there was a significant increase in the odds of mortality for increasing age, diabetes, peripheral vascular disease, having ever smoked and having received dialysis for ≥5 years. Relative to HD, KT recipients had increased odds of death in 2021 and 2022 but not 2020.
The 30-day mortality rate following COVID-19 infection in patients requiring KRT was significantly higher than the general population, with several risk factors identified associated with increased mortality rates.
2019冠状病毒病（COVID-19）大流行对包括慢性肾脏病在内的已有慢性健康问题的患者影响最大。这项回顾性队列研究旨在调查2020年至2022年期间在澳大利亚和新西兰感染COVID-19后接受肾脏替代治疗（KRT）的患者的30天死亡率，包括接受血液透析（HD）、腹膜透析（PD）的患者以及肾移植（KT）受者。
这是一项回顾性队列研究，使用来自澳大利亚和新西兰透析与移植登记处（ANZDATA）的数据。纳入2020年1月首次报告感染至2022年11月底期间接受KRT时COVID-19感染检测呈阳性的患者。采用多变量逻辑回归评估KRT方式与COVID-19感染后30天死亡率之间的关系，纳入所有潜在混杂因素。
2020年至2022年期间，澳大利亚和新西兰共有9828例需要KRT的患者COVID-19检测呈阳性。按KRT方式计算的粗死亡率，HD为3.0%，PD为3.8%，KT为2.4%。在调整模型中，年龄增加、糖尿病、外周血管疾病、曾经吸烟以及接受透析≥5年的患者死亡几率显著增加。与HD相比，KT受者在2021年和2022年死亡几率增加，但在2020年没有增加。
需要KRT的患者感染COVID-19后的30天死亡率显著高于普通人群，已确定了几个与死亡率增加相关的危险因素。
