Sequels of COVID-19 in nephrology. Chronic kidney patients are more prone to hemodialysis need and mortality

Introduction: Acute kidney injury involves inflammation and intrinsic renal damage, and is a common complication of severe coronavirus disease 2019 (COVID-19). Baseline chronic kidney disease (CKD) confers an increased mortality risk. We determined the renal long-term outcomes of COVID-19 in patien...

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Main Authors: Erjola Bolleku, Ermal Likaj, Larisa Shehaj, Ilir Akshija, Edmond Puca, Entela Puca, Xhesi Baci, Alma Idrizi
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2024-12-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/19092
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Summary:Introduction: Acute kidney injury involves inflammation and intrinsic renal damage, and is a common complication of severe coronavirus disease 2019 (COVID-19). Baseline chronic kidney disease (CKD) confers an increased mortality risk. We determined the renal long-term outcomes of COVID-19 in patients with baseline CKD, and the risk factors prompting renal replacement therapy (RRT) initiation and mortality. Methodology: We included 77 patients (median age was 67.1 ± 13.7 years) with a history of renal failure at baseline and recovery from COVID-19 at our institution, in a retrospective analysis from December 2020 to May 2021. Demographic, clinical, and laboratory data were compared between patients requiring RRT and those who did not. A correlogram analysis determined the risk factors for RRT. Survival analysis using the Kaplan-Meier method and Cox regression statistics assessed in-hospital mortality. Results: 70.1% of the patients had CKD. RRT initiation was higher in patients with known CKD (46.4%) than in those with no known CKD (28.5%). Those with diabetic nephropathy had a higher predisposition for RRT initiation compared to other CKD etiologies. Diabetics (42.3%) and hypertensive nephropathy (33%) were the most common etiologies in the general population. Blood urea nitrogen (BUN), creatinine, phosphorus, lactate dehydrogenase, and proteinuria were significantly higher; and platelets and calcium levels were lower; in patients requiring RRT. Decreased lymphocyte count negatively correlated with BUN levels. Conclusions: Known CKD patients had a higher initiation rate of RRT, and laboratory features suggestive of kidney damage. However, RRT patients did not have an increased risk of mortality.
ISSN:1972-2680