ABSTRACT
Objective: The Turkish Society of Nephrology Registry collects data on hemodialysis, peritoneal dialysis, and transplantation annually. Registry reports are printed every year as a booklet, and this is the 30th year of registry reports. Unlike previous years, registry reports include an additional chapter this year due to the coronavirus disease 2019 pandemic. The effect and results of the coronavirus disease-2019 pandemic on kidney replacement therapies are presented in the 2020 reports. Methods: We obtained data from the Turkish Society of Nephrology 2020 registry report and summarized the coronavirus disease-19-associated data and statistics for kidney replacement therapy patients. Results: The number of patients on kidney replacement therapy was 83 350 individuals at the end of 2020. A total of 1610 kidney replacement therapy patients were infected with SARS-CoV-2. Hemodialysis had the highest frequency of coronavirus disease 2019 (19.5%), followed by transplantation (12.2%) and peritoneal dialysis (8.6%). The mortality rate was highest in peritoneal dialysis patients with 29.6%, 24.4% in HD, and 11.2 % in kidney transplant recipients. Conclusion: Coronavirus disease 2019 has significant effects on the survey of patients undergoing kidney replacement therapy through severe complications.
ABSTRACT
Objective: The Turkish Society of Nephrology Registry collects data on hemodialysis, peritoneal dialysis, and transplantation annually. Registry reports are printed every year as a booklet, and this is the 30th year of registry reports. Unlike previous years, registry reports include an additional chapter this year due to the Coronavirus Disease 2019 (COVID-19). The effects and results of the COVID-19 pandemic on kidney replacement therapies are presented in the 2020 reports. Methods: In this article, we obtained data from the Turkish Society of Nephrology 2020 registry report and summarized the coronavirus disease 2019-associated data and statistics for kidney failure with replacement therapy patients. Results: The number of patients on kidney replacement therapies was 83 350 individuals at the end of 2020. Totally, 1610 kidney replacement therapy patients were infected with severe acute respiratory syndrome coronavirus 2. Hemodialysis had the highest frequency of coronavirus disease 2019 (19.5%), followed by transplantation (12.2%) and peritoneal dialysis (8.6%). The mortality rate was highest in peritoneal dialysis patients with 29.6%, 24.4% in hemodialysis, and 11.2% in kidney transplant recipients. Conclusions: Coronavirus disease 2019 has significant effects on the survey of patients undergoing kidney replacement therapies through severe complications. © 2022 Turkish Society of Nephrology. All rights reserved.
ABSTRACT
BACKGROUND AND AIMS: There is not enough data on the post-COVID-19 (coronavirus disease 2019) period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data retrospectively obtained in the follow-up of PD patients after COVID-19 with a control PD group. METHOD: This study, supported by the Turkish Society of Nephrology, is a national multicenter retrospectively case-control study involving adult PD patients with confirmed COVID-19, using data collected from 21 April 2021 to 11 June 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but who did not have COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. RESULTS: A total of 223 patients (COVID-19 group: 113, control group: 110) from 28 centers were included. The duration of PD in both groups was similar [median (IQR):3.0 (1.88-6.0) years and 3.0 (2.0-5.6)], but the patient age of the COVID-19 group was lower than the control group [50 (IQR:40-57) years and 56 (IQR:46-64) years, P < 0.001]. PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on Day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at Day 90. Only one (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition and hypervolemia were significantly higher at Day 90 in the COVID-19 group. CONCLUSION: Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 is not different from the control PD group. However, some of these patients continue to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.
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BACKGROUND AND AIMS: Although existing data suggest an increased mortality rate, data about the course of coronavirus disease 2019 (COVID-19) in peritoneal dialysis (PD) patients, its short-and long-term effects on the patient and technique survival are limited. Moreover, specific factors associated with increased risk of death have not been clearly defined yet. Therefore, we aimed to study the characteristics of PD patients with COVID-19, determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. METHOD: This national multicenter study included all PD patients who had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive reverse transcriptase-polymerase chain reaction testing of a nasopharyngeal swab recorded in this database from the attending 27 PD centers. The demographic data, comorbidities, medications used, PD-related data were recorded as well as clinical, laboratory and radiological findings of COVID-19 and outcomes at the end of the first month were recorded. RESULTS: We enrolled 142 COVID-19 patients (median age: 52 years). A total of 58.2% of patients had mild disease at diagnosis, lung involvement was detected in 60.8% of patients. A total of 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. A total of 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for 4 (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7) and in PD modality change (n = 8) were reported in survivors. During the 1 month from the diagnosis of COVID-19, 26 patients (18.31%) died. The non-survivor group was older and comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement and pleural effusion were more frequent among non-survivors. Age (OR:1.102;95% CI: 1.032- 1.117;P:0.004), moderate-severe clinical disease at presentation (OR:26.825;95% CI: 4.578-157.172;P < 0.001) and CRP levels (OR:1.008;95% CI;1.000-1.016;P:0.040) were associated with increased first-month mortality in multivariate analysis. CONCLUSION: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19 and baseline CRP level are the independent parameters associated with mortality.
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BACKGROUND AND AIMS: Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD: We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS: A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients;15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION: In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. (Table Presented).
ABSTRACT
Objectives: There is limited data about coronavirus disease-19 (COVID-19) characteristics and results in peritoneal dialysis (PD) patients. This study aimed to investigate the characteristics and outcomes among PD patients and compare them with matched hemodialysis (HD) patients and a control group without kidney disease. Methods: We included 18 PD patients and consecutive age- and gender-matched 18 HD and 18 patients without kidney disease (control group) registered into the Turkish Society of Nephrology database including 1301 COVID-19 patients. We compared demographic, clinical, radiological, laboratory data, and outcomes namely intensive care unit (ICU) admission, mechanical ventilation, mortality, and composite outcome (death and/or ICU admission). Results: ICU admission, mechanical ventilation, and mortality rates in PD patients (27.8%, 22.2%, and 22.2%, respectively) and the HD group (16.7%, 11.1%, and 16.7%, respectively) were higher than the control group (11.1%, 11.1%, and 5.6%, respectively), but intergroup comparison did not reveal difference. A total of 11 (20.3%) patients had composite outcome (6 PD patients, 3 HD patients, and 2 patients in the control group). In Cox regression analysis, higher age and higher CRP level were related to increased risk of composite outcome. Adjusted rate of composite outcome in PD group was significantly higher than the control group (P =.050). This rate was similar in HD and control groups (P =.30). Conclusions: Combined in-hospital mortality and/or ICU admission of PD patients with COVID-19 was significantly higher than the control patients. There is a need for careful surveillance of PD patients for infection signs and prompt treatment of COVID-19.
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Objective: The coronavirus disease 2019 (COVID-19) pandemic has currently been one of the leading causes of psychosocial stress throughout the world. We hypothesized that possible changes in anxiety status during the COVID-19 pandemic might affect blood pressure in hemodialysis (HD) patients. Methods: This is an observational cross-sectional study. The Hospital Anxiety and Depression Scale (HADS) and State-Trait Anxiety Inventory (STAI) were applied to 71 prevalent HD patients. Pre-dialysis blood pressure was measured, and the systolic blood pressure measurements of 6 consecutive HD sessions were averaged. All assessments were performed both at the beginning (March) and after the end (June) of the partial lockdown, which was officially instituted by the Government in Turkey. Results: The mean age (+/- SD) was 59.2 +/- 14.8 years and 52% of the patients were female. The STAI-State score was higher in March than in June (44.6 +/- 12.6 vs. 42.3 +/- 11.5, respectively, P =.047), whereas the HADS-Anxiety, HADS-Depression, and STAI-Trait scores were not different. The pre-dialysis systolic blood pressure was significantly higher in March than in June (127.9 +/- 20.3 vs. 124.8 +/- 22.8 mmHg, respectively, P =.029). The change in state anxiety score from March to June was remarkable, particularly in patients not taking a beta-blocker (49.3 +/- 9.6 to 43.8 +/- 11.1, P =.001) and in patients younger than the median age of 64 years (48.6 +/- 12.8 to 45.3 +/- 12.5, P =.029). The change in blood pressure level from March to June was found to be significant only in patients not taking a beta-blocker (123.4 +/- 20.2 to 118.2 +/- 20.6 mmHg, P <.001), while it did not reach a statistically significant level in the others. Conclusion: Our findings revealed an association between a higher state of anxiety and a higher blood pressure level in HD patients during the COVID-19 pandemic, which was remarkable particularly in patients not taking a beta-blocker.
ABSTRACT
BACKGROUND AND AIMS: Coronavirus Disease-19 (COVID-19) pandemic has currently been one of the leading causes of psychosocial stress worldwide. We hypothesized that possible changes in anxiety status might affect blood pressure in haemodialysis (HD) patients during COVID-19 pandemic. METHOD: Seventy one prevalent HD patients were included in this prospective study. Hospital Anxiety and Depression Scale (HADS) and State-Trait Anxiety Inventory (STAI) were applied to assess psychological status of the patients. Peridialysis blood pressure measurements were performed and average of 6 consecutive HD sessions' pre-dialysis systolic blood pressure measurements were used for statistical analyses. All assessments were performed both at the beginning (March) and after ending (June) of the partial lock-down, which was officially instituted by the Government in parallel with the status of the pandemic in Turkey. RESULTS: Mean age (±SD) was 59.2±14.8 years and 52% of the patients were female. Dose of medications including antihypertensives, dry weight, interdialytic weight gain, and Kt/Vurea were stable during the study period. STAI-state score was higher in March than that in June (44.6±12.6 vs 42.3±11.5, respectively, p=0.047), whereas HADS-anxiety, HADS-depression, and STAI-trait scores were not different. Predialysis systolic blood pressure was significantly higher in March than in June (127.9±20.3 vs 124.8±22.8 mmHg, respectively, p=0.029). Change in state anxiety score from March to June was remarkable particularly in patients not taking a betablocker (49.3±9.6 to 43.8±11.1, p=0.001) and in patients younger than the median age of 64 years (48.6±12.8 to 45.3±12.5, p=0.029). Change in blood pressure level from March to June was found to be significant only in patients not taking a beta-blocker (123.4±20.2 to 118.2±20.6 mmHg, p<0.001), while did not reach a statistically significant level in the others. CONCLUSION: Our findings, though need to be confirmed by further studies, revealed an association between a higher state of anxiety and a higher blood pressure level in HD patients in COVID-19 pandemic era, which was remarkable particularly in patients not taking a beta-blocker.