COVID-19 Patients With Pre-existing Kidney Disease Have an Improved Survival Chance

New study results suggest that either the earlier initiation of dialysis or the number of days on dialysis had a significant impact on the survival of hospitalized COVID-19 patients.

Among COVID-19 patients admitted to the intensive care unit (ICU), those who have an abrupt decline in kidney function are more likely to die during hospitalization than those with pre-existing kidney diseases.

This finding is found in a new study being presented at Euroanaesthesia, the annual meeting of the European Society of Anaesthesiology and Intensive Care (ESAIC).

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‘Focusing on the early diagnosis of acute kidney dysfunction can improve the care of critically ill COVID-19 patients.’

A sudden loss of kidney function is known as acute kidney injury (AKI), it affects over a quarter of patients hospitalized with COVID-19.

Previous studies suggest that kidney injury is linked with a higher risk of death in COVID-19 patients. But outcomes of patients hospitalized with COVID-19 and AKI are not well understood.

When AKI is severe, kidney function may be replaced by dialysis that removes toxins and excess fluid and salts that accumulate in the bloodstream.

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To investigate whether AKI in COVID-19 patients without prior kidney disease correlates with higher mortality and whether this risk can be reduced by dialysis, Austrian researchers retrospectively studied all 129 patients who were admitted with confirmed COVID-19 to two intensive care units at a major teaching hospital in Vienna between September 1st, 2020 and February 15th, 2021. The median age of the patients was 66.5 years and two-thirds were male.

Patients were divided into three groups: those with a history of kidney disease at admission; previously healthy kidney patients who developed acute kidney injury on day five of their ICU stay; and those with normal kidney function both before admission and on day five of their ICU stay.

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All patients were followed until the end of their ICU stay. In total, 32 patients needed renal replacement therapy.

Researchers found that 55% (18 of 33) of patients with a history of kidney disease, 46% (12 of 26) of patients with AKI, and 83% (58 of 70) of patients with normal kidney function survived their ICU stay, showing a highly significant difference in survival between the three groups.

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In the two groups with kidney dysfunction, the likelihood of survival was significantly below average, indicating a higher risk of dying compared to normal kidney function.

These findings confirm that kidney dysfunction is a key risk factor for COVID-19-related death in intensive care patients. They also suggest that COVID-19 patients who develop acute kidney injury face a higher risk of dying in the ICU than those with pre-existing chronic kidney disease.

Researchers hope to do further research to better understand how different factors impact outcomes in this population and develop further insights about how to best treat this high-risk population.

Source-Medindia