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Clotting of Hemodialysis Access in Patients with COVID-19 in an Inner-City Hospital.
Ouyang, Jie; Bajracharya, Siddhartha; John, Sabu; Wagner, John; Xu, Jiehui; Luo, Yiming; Thaxton, Mariah; Salifu, Moro; Yap, Ernie; Mallappallil, Mary.
  • Ouyang J; NYC Health + Hospitals, Kings County Hospital Center, Brooklyn, New York, USA, jie.ouyang@downstate.edu.
  • Bajracharya S; Downstate Medical Center- State University of Brooklyn, Brooklyn, New York, USA, jie.ouyang@downstate.edu.
  • John S; NYC Health + Hospitals, Kings County Hospital Center, Brooklyn, New York, USA.
  • Wagner J; Downstate Medical Center- State University of Brooklyn, Brooklyn, New York, USA.
  • Xu J; NYC Health + Hospitals, Kings County Hospital Center, Brooklyn, New York, USA.
  • Luo Y; Downstate Medical Center- State University of Brooklyn, Brooklyn, New York, USA.
  • Thaxton M; NYC Health + Hospitals, Kings County Hospital Center, Brooklyn, New York, USA.
  • Salifu M; Division of Biostatistics, New York University, New York, New York, USA.
  • Yap E; Rheumatology, National Institute of Arthritis and Musculoskeletal and Skin Disease, Bethesda, Maryland, USA.
  • Mallappallil M; NYC Health + Hospitals, Kings County Hospital Center, Brooklyn, New York, USA.
Nephron ; 146(2): 179-184, 2022.
Article in English | MEDLINE | ID: covidwho-1582865
ABSTRACT

BACKGROUND:

An increased incidence of thrombotic complications in patients with coronavirus disease 2019 (COVID-19) has been reported. Severe acute kidney injury (AKI) is one of the major clinical manifestations of COVID-19 with the need for renal replacement therapy. It was observed that hemodialysis (HD) accesses tended to thrombose more often in the COVID-19 population than in non-COVID-19 patients. We hypothesize that the hypercoagulable state of COVID-19 is associated with higher incidence of access clotting.

METHOD:

In this retrospective single-centered study at Kings County Hospital in New York City, 1,075 patients with COVID-19 were screened, and 174 patients who received HD from January 3, 2021 to May 15, 2020 were enrolled to examine the risk factors of dialysis access clotting in patients with COVID-19.

RESULTS:

Of the 174 patients, 109 (63%) were COVID-19 positive. 39 (22.6%) patients had dialysis access clotting at least once during their hospitalization, and they had significantly higher body mass index (BMI) (p = 0.001), higher rates of COVID-19 (p = 0.015), AKI (p < 0.001), higher platelet counts (p = 0.029), higher lactate dehydrogenase levels (p = 0.009), and lower albumin levels (p = 0.001) than those without access malfunctions. Low albumin levels (p = 0.008), AKI (p = 0.008), and high BMI (p = 0.018) were risk factors associated with HD access clotting among COVID-19 patients.

CONCLUSION:

Patients with COVID-19 who receive HD for AKI with high BMI are at a higher risk of clotting their HD access.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Hospitals, Urban / Renal Dialysis / Acute Kidney Injury / Vascular Access Devices / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Nephron Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Hospitals, Urban / Renal Dialysis / Acute Kidney Injury / Vascular Access Devices / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Nephron Year: 2022 Document Type: Article