Background: Reports would suggest a more severe disease course in patients with chronic kidney disease, although outcomes in maintenance hemodialysis patients are still unclear, with earlier small case series suggesting a milder course. Management of maintenance hemodialysis patients in the context of an epidemic poses several challenges: this group of patients usually requires caregiver assistance and transportation from home to the dialysis units, and they must spend time in crowded waiting areas before and after treatment. Moreover, maintenance hemodialysis patients are usually old and affected by several comorbidities that are known to be associated with high risk of poor outcomes in patients with COVID-19.
Objectives: To describe the clinical setting, treatment and clinical outcomes of COVID-19 in patients with chronic kidney disease Stage 5D. To describe epidemiological features and risk factors affecting outcome in end stage renal disease patients with COVID-19 infection.
Patients and Methods: This is a retrospective observational multicentre study included 33 patients with end stage renal disease on conventional hemodialysis from January 2021 to April 2021. The study was conducted in Nephrology Unit Bap El-Sharia, UniversityHospital and MenofiaUniversityHospital.
Results: 33 patients were eligible for final analysis, they had a mean age 61.24± 9.17 years old, and a mean weight 70.73 ± 17.68 Kg males represented 54.5% of the included patients, moreover, 45.5% of the included patients were smokers. prevalence of diabetes was significantly higher among patients who survived with p value 0.011, contrary, obesity was more prevalence among the expired group with p value 0.017, however, prevalence of hypertension, peripheral vascular disease, cardiac disease, chronic respiratory disease and malignancy was not significantly different between both groups with p values >0.05 each. Regarding laboratory findings, blood urea nitrogen (BUN) pre-dialysis was significantly higher among patients who died after being infected with COVID-19 with p value 0.03, Albumin was significantly higher among patients who recovered and was discharged after COVID-19 infection with p value 0.002, and C-reactive protein (CRP) was significantly higher in the expired group with p value 0.03. All Infected patients who failed to achieve weaning of mechanical ventilation died in the current cohort.
Conclusion: There was no significant difference in primary kidney disease of COVID19 hemodialysis patients and mechanical ventilation. There was no significant difference in laboratory finding, severity of hemodialysis and comorbidities of COVID19 hemodialysis patients and mechanical ventilation.