ABSTRACT
Introduction: COVID-19 still poses a high morbidity and mortality in chronic kidney disease. We aim to determine the risk factors for mortality amongst hospitalised COVID-19 patients with kidney disease. Material(s) and Method(s): This is an observational cohort study involving all COVID-19 patients with kidney disease in the first quarter of 2021. Relevant data was extracted from the electronic medical records and statistical analysis was conducted using SPSS version 26. Result(s): Of 414 COVID-19 patients, 165 (39.9%) had kidney disease [25.5% end stage kidney disease (ESKD), 4.2% chronic kidney disease (CKD) and 70.3% acute kidney injury (AKI)). 56 of them died, giving an inpatient mortality rate of 33.9% in patients with kidney disease compared to 17.1% from all COVID-19 admissions. ESKD had the highest mortality rate at 42.9% followed by AKI, 31% and CKD, 28.6% (p=0.365). Majority of patients with kidney disease who died, were older (66 +/- 10.4 vs 54 +/- 14.6, p<0.001), male (78.6% vs 61.5%, p=0.035) and had category 5 infection (28.6% vs 19.3%;p=0.009). 66.1% were on mechanical ventilation while 51.8% were managed in the intensive care unit. Multiple logistic regression predicted older age, premorbid CKD & ESKD, raised peak serum sodium, admission category of illness 4 & 5, mechanical ventilation and unknown epidemiology link to increase mortality risk in patients with COVID-19 infection with kidney disease. Conclusion(s): COVID-19 mortality rate remains high amongst those with ESKD, CKD and AKI. Future studies should evaluate the incidence and outcome post vaccination.