TY - JOUR
T1 - COVID-19-related mortality in kidney transplant and dialysis patients
T2 - Results of the ERACODA collaboration
AU - Hilbrands, Luuk B.
AU - Duivenvoorden, Raphal
AU - ERACODA Collaborators
AU - Vart, Priya
AU - Franssen, Casper F.M.
AU - Hemmelder, Marc H.
AU - Jager, Kitty J.
AU - Kieneker, Lyanne M.
AU - Noordzij, Marlies
AU - Pena, Michelle J.
AU - de Vries, Hanne
AU - Arroyo, David
AU - Covic, Adrian
AU - Crespo, Marta
AU - Goffin, Eric
AU - Islam, Mahmud
AU - Massy, Ziad A.
AU - Montero, Nuria
AU - Oliveira, João P.
AU - Muñoz, Ana Roca
AU - Sanchez, J. Emilio
AU - Sridharan, Sivakumar
AU - Winzeler, Rebecca
AU - Gansevoort, Ron T.
AU - du Buf-Vereijken, Peggy W.G.
AU - van Ginneken, Betty
AU - Vogt, Liffert
AU - van Jaarsveld, Birgit C.
AU - Bemelman, Frederike J.
AU - Klingenberg-Salahova, Farah
AU - Heenan-Vos, Frederiek
AU - Vervloet, Marc G.
AU - Nurmohamed, Azam
AU - Abramowicz, Daniel
AU - Verhofstede, Sabine
AU - Maoujoud, Omar
AU - Fialova, Jana
AU - Melilli, Edoardo
AU - Favà, Alex
AU - Cruzado, Josep M.
AU - Lips, Joy
AU - van de Wetering, Jacqueline
N1 - FUNDING
The ERACODA Consortium is financially supported by unrestricted grants from the ERA-EDTA, the Dutch Kidney Foundation, Baxter and Sandoz. None of these organizations
had any role in the design or execution of the study, nor in
writing of the manuscript.
Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
PY - 2020/11
Y1 - 2020/11
N2 - Background. Patients on kidney replacement therapy comprise a vulnerable population and may be at increased risk of death from coronavirus disease 2019 (COVID-19). Currently, only limited data are available on outcomes in this patient population. Methods. We set up the ERACODA (European Renal Association COVID-19 Database) database, which is specifically designed to prospectively collect detailed data on kidney transplant and dialysis patients with COVID-19. For this analysis, patients were included who presented between 1 February and 1 May 2020 and had complete information available on the primary outcome parameter, 28-day mortality. Results. Of the 1073 patients enrolled, 305 (28%) were kidney transplant and 768 (72%) dialysis patients with a mean age of 60 6 13 and 67 6 14 years, respectively. The 28-day probability of death was 21.3% [95% confidence interval (95% CI) 14.3–30.2%] in kidney transplant and 25.0% (95% CI 20.2–30.0%) in dialysis patients. Mortality was primarily associated with advanced age in kidney transplant patients, and with age and frailty in dialysis patients. After adjusting for sex, age and frailty, in-hospital mortality did not significantly differ between transplant and dialysis patients [hazard ratio (HR) 0.81, 95% CI 0.59–1.10, P ¼ 0.18]. In the subset of dialysis patients who were a candidate for transplantation (n ¼ 148), 8 patients died within 28 days, as compared with 7 deaths in 23 patients who underwent a kidney transplantation <1 year before presentation (HR adjusted for sex, age and frailty 0.20, 95% CI 0.07–0.56, P < 0.01). Conclusions. The 28-day case-fatality rate is high in patients on kidney replacement therapy with COVID-19 and is primarily driven by the risk factors age and frailty. Furthermore, in the first year after kidney transplantation, patients may be at increased risk of COVID-19-related mortality as compared with dialysis patients on the waiting list for transplantation. This information is important in guiding clinical decision-making, and for informing the public and healthcare authorities on the COVID-19-related mortality risk in kidney transplant and dialysis patients.
AB - Background. Patients on kidney replacement therapy comprise a vulnerable population and may be at increased risk of death from coronavirus disease 2019 (COVID-19). Currently, only limited data are available on outcomes in this patient population. Methods. We set up the ERACODA (European Renal Association COVID-19 Database) database, which is specifically designed to prospectively collect detailed data on kidney transplant and dialysis patients with COVID-19. For this analysis, patients were included who presented between 1 February and 1 May 2020 and had complete information available on the primary outcome parameter, 28-day mortality. Results. Of the 1073 patients enrolled, 305 (28%) were kidney transplant and 768 (72%) dialysis patients with a mean age of 60 6 13 and 67 6 14 years, respectively. The 28-day probability of death was 21.3% [95% confidence interval (95% CI) 14.3–30.2%] in kidney transplant and 25.0% (95% CI 20.2–30.0%) in dialysis patients. Mortality was primarily associated with advanced age in kidney transplant patients, and with age and frailty in dialysis patients. After adjusting for sex, age and frailty, in-hospital mortality did not significantly differ between transplant and dialysis patients [hazard ratio (HR) 0.81, 95% CI 0.59–1.10, P ¼ 0.18]. In the subset of dialysis patients who were a candidate for transplantation (n ¼ 148), 8 patients died within 28 days, as compared with 7 deaths in 23 patients who underwent a kidney transplantation <1 year before presentation (HR adjusted for sex, age and frailty 0.20, 95% CI 0.07–0.56, P < 0.01). Conclusions. The 28-day case-fatality rate is high in patients on kidney replacement therapy with COVID-19 and is primarily driven by the risk factors age and frailty. Furthermore, in the first year after kidney transplantation, patients may be at increased risk of COVID-19-related mortality as compared with dialysis patients on the waiting list for transplantation. This information is important in guiding clinical decision-making, and for informing the public and healthcare authorities on the COVID-19-related mortality risk in kidney transplant and dialysis patients.
UR - http://www.scopus.com/inward/record.url?scp=85095861968&partnerID=8YFLogxK
U2 - 10.1093/ndt/gfaa261
DO - 10.1093/ndt/gfaa261
M3 - Article
C2 - 33151337
AN - SCOPUS:85095861968
SN - 0931-0509
VL - 35
SP - 1973
EP - 1983
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 11
ER -