Factors related to mortality in patients with stage 5 chronic kidney disease on dialysis with COVID-19: An exploratory case series analysis

Author:

Venegas Justiniano YanissaORCID,Loza Munarriz CésarORCID,Hurtado Aréstegui AbdíasORCID

Abstract

Introduction Different studies describe the clinical profile and factors that could explain the evolution and outcome of patients with chronic kidney disease and COVID-19. This study aims to evaluate the factors related to the mortality of patients with stage-5 chronic kidney disease on chronic dialysis hospitalized for COVID-19 at the Hospital Nacional Arzobispo Loayza from April to December 2020. Methods Retrospective case series and exploratory analysis were performed. Patients with stage-5 chronic kidney disease on dialysis, older than 18 years, and hospitalized for COVID-19 disease were included. Hospital medical records were the primary data source. Results A total of 105 medical records were reviewed. 57 were male (54.3%), with a mean age of 58.6 years (standard deviation: 14.3). Eighty-four patients survived (80%), and 21 died (20%). The main cause of hospital admission, present in 80 patients (76.2%), was respiratory failure; the mean hospital stay was of 11.8 days (SD: 7.8). In the bivariate analysis: patients with moderate to severe COVID-19, overweight and obesity, increased levels of leukocytes, D-dimer, ferritin, C-reactive protein, lactate dehydrogenase, as well as, decreased levels of lymphocytes, bicarbonate and arterial oxygen pressure/inspired oxygen fraction were related to mortality risk. In multivariate analysis, only severe COVID-19 disease (OR 1.48; 95% CI 2.24 to 7.77), C-reactive protein > 10 mg/dL (OR: 9.72; 95% CI: 1.41 to 18.58), and arterial oxygen pressure/inspired oxygen fraction ≤ 150 millimeters of mercury (OR: 10.23; 95% CI: 5.87 to 36.06) were factors associated with poor survival. Conclusions In patients with stage-5 chronic kidney disease hospitalized for COVID-19, severe COVID-19 disease, C-protein reactive levels > 10 milligrams per deciliter, arterial oxygen pressure / inspired oxygen fraction ≤ 150 millimeters of mercury and severe COVID-19 disease were the main factors related to mortality.

Publisher

Medwave Estudios Limitada

Subject

General Medicine

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