COVID-19 mortality alarmingly high in dialysis patients
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At the Opening Conference of the ERA-EDTA Congress, Dr. Maria Jose Soler Romeo presented data gathered at the Hospital Vall d'Hebron. Of 400 dialysis patients, 21 had COVID-19. The figures obtained from the Hospital on the incidence of COVID-19 are not representative, of course, as it is only one center, but they do indicate a significantly higher rate of infection for dialysis patients.

Of the 21 dialysis patients who contracted COVID-19, 15 were discharged, one was on the ICU at the time of the survey, and five had died. The mortality rate in this center was 24%. This high death rate among infected dialysis patients was also verified in an analysis of the Spanish COVID-19 Dialysis/Transplantation Registry, which included a total of 1572 end-stage renal disease (ESRD) patients, including 998 hemodialysis (HD) patients, 51 PD patients and 523 kidney transplant patients.

The mortality rate among HD patients was more than 27% for the whole Spain, but was also more than 23% for kidney transplant patients. PD patients had a significantly lower mortality rate of 15%, but their number is so small in proportion that it is almost impossible to make statistically valid statements about this patient group.

The high mortality rate among dialysis patients was also verified in a study that monitored the course of disease in 36 HD patients between March 12 and April 10 in Hospital Gregorio Marañón in Madrid.

The death rate here was as high as 30.5%, but what is particularly interesting about this study is that it analyzed predictors of mortality.

The conclusion was that, in addition to patient older age and pneumonia, there are three factors that significantly influence the mortality rate among coronavirus-positive dialysis patients: (1) the number of years on dialysis (dialysis vintage), (2) lymphopenia, which describes a low number of special white blood cells (lymphocytes) that protect the body from infections, and (3) elevated LDH levels, a surrogate for tissue damage.

Source: https://www.kidney-international.org/article/S0085-2538(20)30509-3/pdf
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