Impact of Renal Replacement Therapy Modality on Prognosis of
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Prognosis of SARS-CoV2 infection among patients with Chronic Kidney Disease (CKD) is poorly known. In particular, the impact of renal replacement therapy (RRT) modality on prognosis is undetermined. Patients with kidney transplant exhibit treatment-induced immunodepression, while patients on dialysis are usually older and exhibit higher frailty. Researchers aimed to determine the impact of RRT modality on the prognosis of SARS-CoV2 infection among patient with advanced CKD.

They conducted a retrospective cohort study using institution’s Clinical Data Warehouse. Health records of all patients with at least one hozpitalization or consultation in our nephrology department were screened based on ICD-10 codes. Inclusion criteria were: hospitalization in any of our institution’s hospitals for SARS-CoV2 infection. Patients were divided into two groups: active kidney transplant and dialysis. A Cox model stratifying on age and medical history of coronary artery disease was used to determine adjusted Hazard Ratio (HR) for death or ICU admission.

They included 72 patients: 47 in the transplant group and 25 in the dialysis group. First hospitalization was on 20/02/28 and last hospitalization on 20/05/19. Median follow-up was 21.5 days. Death or ICU admission occurred in 21 (29%) patients, transplant group: 15 (32%), dialysis group: 6 (24%). In multivariate analysis, adjusted HR for death or ICU admission was 1.70 for transplant vs. dialysis.

Conclusively, in this study, among patients hospitalized for SARS-CoV2 infection, no significant difference in risk for ICU hospitalization or death was found between CKD patients on dialysis or with active kidney transplant. A trend for higher risk was noted among patients with active kidney transplant. Further studies are required to confirm those findings.