COVID 19 IMPAIRS ENDOTHELIAL FUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON HEMODIALYSIS

ABSTRACT

Introduction: Cardiovascular events are the leading cause of mortality in patients with chronic kidney disease on hemodialysis (CKD-HD). Recent evidence suggests that coronavirus-19 disease (COVID-19) would induce vascular endothelial function alterations to increase cardiovascular risk. However, whether COVID-19 contributes to endothelial dysfunction in patients with CKD-HD is unclear. Objective: To assess whether COVID-19 worsens endothelial function in a cohort of patients with chronic kidney disease on hemodialysis. Materials and Methods: Patients with chronic kidney disease on hemodialysis were divided into those without COVID-19 (CKD;n = 68) and mild COVID-19 (CKD-C19;n = 11, WHO criteria and PCR+). Informed consent was obtained. Systolic (SBP), diastolic (DBP) and mean (MAP) blood pressures, heart rate (HR), and endothelial function (EF) were evaluated for reactive hyperemia. It was determined dry weight, height, fat mass index (FMI), muscle mass index (MMI), and body mass index (BMI). Results were compared with normal people without CKD (Control = C, n = 10). Results: CKD and CKD-C19 presented a high SBP compared to the controls and without differences between them (C 119 ± 3, n = 10 vs. CKD 145 ± 2, n = 68 vs. CKD-C19 143 ± 3 mmHg, n = 11;p < 0.05 vs. C). Patients CKD-C 19 presented greater endothelial dysfunction compared to CKD and the control group (EF CKD-C192 ± 1, n = 11 vs CKD4.5 ± 1, n = 28 vs. C12.1 ± 1, n = 10;p < 0.05). In CKD and C-C19 an increase in BMI was observed in conjunction with an increase in fat mass, without differences in the muscle mass index between both groups (X2p NS). No association was observed between EF and BMI or IMG. Conclusions: The present study indicates that COVID-19 would aggravate endothelial dysfunction in patients with chronic kidney disease on hemodialysis. This would not be related to increased BMI or elevated blood pressure. However, more studies are needed to determine the role of COVID-19 on vascular function in this population. (Table Presented).