MORTALITY OF PATIENTS WITH CKD AND ITs RISK FACTORS ADMITTED TO HOSPITAL WITH COVID-19 IN ALMATY CITY KAZAKHSTAN BETWEEN 2020-2022

ABSTRACT

Introduction: The global prevalence of chronic kidney disease (CKD) is approximately between 9 and 12%. One of the main predictors of CKD is elderly age, and about 38% of patients are older than 65 years of age. People with CKD have impairment of the normal reaction of the innate and adaptive immune systems. Therefore, this cohort of patients is more predisposed to chronic comorbid conditions and viral infections. The COVID-19 pandemic shifted the morbidity and mortality of people with CKD. The research shows that patients with kidney disease were more likely to have worse outcomes from coronavirus infection compared to patients without CKD. The aim of this study is to investigate in-hospital mortality of CKD patients and its risk factors with coronavirus in Almaty, Kazakhstan. Method(s) The retrospective analysis includes patients, who had been admitted to a hospital with coronavirus infection, in the Almaty region of Kazakhstan, between June 2020 and June 2022. The database was extracted from the Unified National Electronic Healthcare System (UNEHS). Patients were included if they had been hospitalized with the main diagnosis of U07.1 (COVID-19, virus identified) and U07.2. (COVID-19, virus not identified). Patients' unique IDs were used to merge the database of CKD patients to define whether they had the disease or not. The statistical analysis was performed with STATA 16.0. Person's chi-square test was used for bivariate analysis, and Logistic regression was used for estimation of the relationship between in-hospital mortality and predictors. Result(s) The final cohort consisted of 58,970 patients, and 929 (2%) of them had CKD. The age of patients with kidney disease was statistically significantly higher than that of the comparison group (Table 1). As for the comorbid conditions, CKD patients had a higher ratio of acute myocardial infarction (AMI), diabetes, hypertension, congestive heart failure (CHF), and cerebrovascular disease (CVD) compared to the reference group. The mortality ratio was statistically significantly different in two groups. Table 1. Demographic characteristics and comorbidities of patients with and without CKD. [Formula presented] People of elderly age, male gender, having CKD, AMI, diabetes, hypertension, CHF, and CVD had higher odds of death according to unadjusted logistic regression (Table 2). After adjustment for the abovementioned predictors, age, male gender, CKD, diabetes, and CVD showed higher risks of mortality and remained statistically significant. Table 2. Association between socio-demographic and medical characteristics and in-hospital mortality of patients. [Formula presented] Conclusion(s) This research evaluated hospitalization outcomes of coronavirus patients with and without CKD in Almaty, Kazakhstan. The effect of socio-demographic factors and comorbidities on mortality was analyzed. Although CKD can be prevented and treated to a large extent, multimorbid conditions, especially viruses causing a pandemic, can alter the situation. Therefore, it is necessary to establish a comprehensive disease management strategy for unexpected infectious disease outbreaks. No conflict of interestCopyright © 2023