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BMC Infect Dis
. 2024 May 25;24(1):527.
doi: 10.1186/s12879-024-09414-w. Prognostic significance of chronic kidney disease and impaired renal function in Japanese patients with COVID-19
Hiromu Tanaka 1 , Shotaro Chubachi # 2 , Takanori Asakura # 3 4 5 , Ho Namkoong 6 , Shuhei Azekawa 1 , Shiro Otake 1 , Kensuke Nakagawara 1 , Takahiro Fukushima 1 , Ho Lee 1 , Mayuko Watase 1 , Kaori Sakurai 1 , Tatsuya Kusumoto 1 , Katsunori Masaki 1 , Hirofumi Kamata 1 , Makoto Ishii 1 7 , Naoki Hasegawa 6 , Yukinori Okada 8 9 10 , Ryuji Koike 11 , Yuko Kitagawa 12 , Akinori Kimura 13 , Seiya Imoto 14 , Satoru Miyano 15 , Seishi Ogawa 16 , Takanori Kanai 17 , Koichi Fukunaga 1
Affiliations
Background: Renal impairment is a predictor of coronavirus disease (COVID-19) severity. No studies have compared COVID-19 outcomes in patients with chronic kidney disease (CKD) and patients with impaired renal function without a prior diagnosis of CKD. This study aimed to identify the impact of pre-existing impaired renal function without CKD on COVID-19 outcomes.
Methods: This retrospective study included 3,637 patients with COVID-19 classified into three groups by CKD history and estimated glomerular filtration rate (eGFR) on referral: Group 1 (n = 2,460), normal renal function without a CKD history; Group 2 (n = 905), impaired renal function without a CKD history; and Group 3 (n = 272), history of CKD. We compared the clinical characteristics of these groups and assessed the effect of CKD and impaired renal function on critical outcomes (requirement for respiratory support with high-flow oxygen devices, invasive mechanical ventilation, or extracorporeal membrane oxygen, and death during hospitalization) using multivariable logistic regression.
Results: The prevalence of comorbidities (hypertension, diabetes, and cardiovascular disease) and incidence of inflammatory responses (white blood counts, and C-reactive protein, procalcitonin, and D-dimer levels) and complications (bacterial infection and heart failure) were higher in Groups 2 and 3 than that in Group 1. The incidence of critical outcomes was 10.8%, 17.7%, and 26.8% in Groups 1, 2, and 3, respectively. The mortality rate and the rate of requiring IMV support was lowest in Group 1 and highest in Group 3. Compared with Group 1, the risk of critical outcomes was higher in Group 2 (adjusted odds ratio [aOR]: 1.32, 95% confidence interval [CI]: 1.03-1.70, P = 0.030) and Group 3 (aOR: 1.94, 95% CI: 1.36-2.78, P < 0.001). Additionally, the eGFR was significantly associated with critical outcomes in Groups 2 (odds ratio [OR]: 2.89, 95% CI: 1.64-4.98, P < 0.001) and 3 (OR: 1.87, 95% CI: 1.08-3.23, P = 0.025) only.
Conclusions: Clinicians should consider pre-existing CKD and impaired renal function at the time of COVID-19 diagnosis for the management of COVID-19.
Keywords: COVID-19; Estimated glomerular filtration rate; Japanese population; Renal insufficiency.
. 2024 May 25;24(1):527.
doi: 10.1186/s12879-024-09414-w. Prognostic significance of chronic kidney disease and impaired renal function in Japanese patients with COVID-19
Hiromu Tanaka 1 , Shotaro Chubachi # 2 , Takanori Asakura # 3 4 5 , Ho Namkoong 6 , Shuhei Azekawa 1 , Shiro Otake 1 , Kensuke Nakagawara 1 , Takahiro Fukushima 1 , Ho Lee 1 , Mayuko Watase 1 , Kaori Sakurai 1 , Tatsuya Kusumoto 1 , Katsunori Masaki 1 , Hirofumi Kamata 1 , Makoto Ishii 1 7 , Naoki Hasegawa 6 , Yukinori Okada 8 9 10 , Ryuji Koike 11 , Yuko Kitagawa 12 , Akinori Kimura 13 , Seiya Imoto 14 , Satoru Miyano 15 , Seishi Ogawa 16 , Takanori Kanai 17 , Koichi Fukunaga 1
Affiliations
- PMID: 38796423
- DOI: 10.1186/s12879-024-09414-w
Background: Renal impairment is a predictor of coronavirus disease (COVID-19) severity. No studies have compared COVID-19 outcomes in patients with chronic kidney disease (CKD) and patients with impaired renal function without a prior diagnosis of CKD. This study aimed to identify the impact of pre-existing impaired renal function without CKD on COVID-19 outcomes.
Methods: This retrospective study included 3,637 patients with COVID-19 classified into three groups by CKD history and estimated glomerular filtration rate (eGFR) on referral: Group 1 (n = 2,460), normal renal function without a CKD history; Group 2 (n = 905), impaired renal function without a CKD history; and Group 3 (n = 272), history of CKD. We compared the clinical characteristics of these groups and assessed the effect of CKD and impaired renal function on critical outcomes (requirement for respiratory support with high-flow oxygen devices, invasive mechanical ventilation, or extracorporeal membrane oxygen, and death during hospitalization) using multivariable logistic regression.
Results: The prevalence of comorbidities (hypertension, diabetes, and cardiovascular disease) and incidence of inflammatory responses (white blood counts, and C-reactive protein, procalcitonin, and D-dimer levels) and complications (bacterial infection and heart failure) were higher in Groups 2 and 3 than that in Group 1. The incidence of critical outcomes was 10.8%, 17.7%, and 26.8% in Groups 1, 2, and 3, respectively. The mortality rate and the rate of requiring IMV support was lowest in Group 1 and highest in Group 3. Compared with Group 1, the risk of critical outcomes was higher in Group 2 (adjusted odds ratio [aOR]: 1.32, 95% confidence interval [CI]: 1.03-1.70, P = 0.030) and Group 3 (aOR: 1.94, 95% CI: 1.36-2.78, P < 0.001). Additionally, the eGFR was significantly associated with critical outcomes in Groups 2 (odds ratio [OR]: 2.89, 95% CI: 1.64-4.98, P < 0.001) and 3 (OR: 1.87, 95% CI: 1.08-3.23, P = 0.025) only.
Conclusions: Clinicians should consider pre-existing CKD and impaired renal function at the time of COVID-19 diagnosis for the management of COVID-19.
Keywords: COVID-19; Estimated glomerular filtration rate; Japanese population; Renal insufficiency.