Introduction: We aimed to study the characteristics of peritoneal dialysis (PD) patients with coronavirus disease-19 (COVID-19), determine the short-term mortality and other medical complications, ...and delineate the factors associated with COVID-19 outcome. Methods: In this multicenter national study, we included PD patients with confirmed COVID-19 from 27 centers. The baseline demographic, clinical, laboratory, and radiological data and outcomes at the end of the first month were recorded. Results: We enrolled 142 COVID-19 patients (median age: 52 years). 58.2% of patients had mild disease at diagnosis. Lung involvement was detected in 60.8% of patients. Eighty-three (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. Fifteen (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for four (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7), and in PD modality change (n = 8) were reported in survivors. Twenty-six patients (18.31%) died in the first month of diagnosis. The non-survivor group was older, comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement, and pleural effusion were more frequent among non-survivors. Age (OR: 1.102; 95% CI: 1.032–1.117; p: 0.004), moderate-severe clinical disease at presentation (OR: 26.825; 95% CI: 4.578–157.172; p < 0.001), and baseline CRP (OR: 1.008; 95% CI; 1,000–1.016; p: 0.040) were associated with first-month mortality in multivariate analysis. Discussion/Conclusions: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19, and baseline CRP level are the independent parameters associated with mortality.
There are not enough data on the post-CO-VID-19 period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data of PD patients after COVID-19 ...with a control PD group.
This study, supported by the Turkish Society of Nephrology, is a national, multicenter retrospective case-control study involving adult PD patients with confirmed COVID-19, using data collected from April 21, 2021, to June 11, 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but without COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated.
A total of 223 patients (COVID-19 group: 113, control group: 110) from 27 centers were included. The duration of PD in both groups was similar (median IQR: 3.0 1.88-6.0 years and 3.0 2.0-5.6), but the patient age in the COVID-19 group was lower than that in the control group (50 IQR: 40-57 years and 56 IQR: 46-64 years, p < 0.001). PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure, and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at day 90. Only 1 (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition, and hypervolemia were significantly higher at day 90 in the COVID-19 group.
Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 was not different from the control PD group. However, some patients continued to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.
Amaç: Son dönem böbrek yetmezliği belirgin morbidite ve mortalite ile toplumda oldukça yaygındır. Böbrek yetmezliği olan hastalarda, yaşam kalitesini ve sağ kalımı arttırdığı için böbrek nakli etkin ...bir tedavi seçeneğidir. Bu çalışmanın amacı yeni hizmete giren böbrek nakil merkezindeki ilk sonuçları değerlendirmektir.Materyal ve Metot: Nisan 2019 ile Ekim 2019 tarihleri arasında, Sakarya Üniversitesi Eğitim Araştırma Hastanesi Böbrek Nakil Merkezi’nde böbrek yetmezliği nedeniyle nakil yapılan 20 hasta retrospektif olarak değerlendirildi. Hastaların ve donörlerin demografik özellikleri kaydedildi ve operasyon öncesi ve sonrası laboratuvar sonuçları değerlendirildi. Posttransplantasyon akut komplikasyonları kaydedildi. Verileri uygun istatistik yöntemi (ortalama ±standart sapma ve ortanca(min,max)) ile değerlendirildi.Bulgular: Böbrek alıcıların ortalama yaşı 46,10±11,52 yıl, Vucut kitle indeksi (VKİ) 27,00±6,00 idi ve %40’ı kadın %60’ı erkekti. Nakil yapılan hastaların operasyon sonrası ortalama serum kreatinin 1.gün:3,10±1,60 mg/dl, 7.gün:1,17±0,36 mg/dl, 3.ay:1,07±0,26 mg/dl, 6. Ay:1,10±0,28 mg/dl idi.Sonuç: Son dönem böbrek yetmezliği olan hastalığı olan hastalarda yapılan böbrek nakil operasyonu kısa dönem sonuçlarının başarılı olduğu görülmektedir. Laparoskopik donör nefrektomi uygun vericilerde ilk tercih edilmesi gereken yaklaşımdır. Son dönem böbrek yetmezliği olan hastalara mümkün olduğunca böbrek nakli gerçekleştirilmesi hem hasta sağ kalımı hem de ekonomik maliyet açısından önerilen tedavi yöntemdir.
Objective: End-stage renal failure is quite common in the community with pronounced morbidity and mortality. Kidney transplantation is an effective treatment option in patients with renal insufficiency as it improves quality of life and survival. The aim of this study is to evaluate the first results in currently introduced kidney transplant center.Materials and Methods: Between April 2019 and October 2019, 20 patients who were transplanted due to kidney failure at the Sakarya University Training and Research Hospital Kidney Transplant Center were evaluated retrospectively. The demographic characteristics of the patients and donors were recorded and the laboratory results before and after the operation were evaluated. Acute complications of posttransplantation were recorded. The data were evaluated by appropriate statistical method (overall ± standard deviation and median (min, max)).Results: The average age of kidney recipients was 46.10 ± 11.52 years, BMI was 27.00 ± 6.00, and 40% were female and 60% were male. Average serum creatinine after the operation of patients who were transplanted 1.day: 3.10 ± 1.60 mg / dl, 7.day: 1,17±0,36 mg / dl, 3.month: 1,07±0,26 mg / dl, 6th month: 1,10±0,28 mg / dl.Conclusion: The short-term results of kidney transplantation performed in patients with end-stage renal failure appear to be successful. Laparoscopic donor nephrectomy is the first choice approach in appropriate donors. Performing kidney transplantation as much as possible to patients with end-stage renal failure is the recommended treatment method in terms of both patient survival and economic costs.
Objective: We aimed to evaluate the long-term graft functions of kidney transplant recepients (KTR) who have been cured of the COVID-19 and to investigate the role of inactivated COVID-19 vaccine in ...the clinical course of the disease.Materials and Methods: KTR who had COVID-19 pneumonia between March 2020 and September 2021 were included in the study.. The clinical course of the disease was evaluated in vaccinated patients and compared with those who were not vaccinated. The laboratory information of the patients at the time of admission to the hospital, 6 months and 12 months after the disease was recorded.Results: Of the 83 patients included, 67.5% were male. COVID-19 disease developed in 20 patients after vaccination. Vaccine; it decreased the development of acute kidney injury (AKI) 5.9 fold and hospitalization in the intensive care unit (ICU) 1.4 times fold (p<0.05). In the follow-up, 10 patients died at the first admission to the hospital and no late death was recorded in the first year. Dialysis treatment was started in 5 patients due to graft loss.Conclusion: In kidney transplant patients, graft dysfunction may develop after COVID-19 infection. However, the inactivated COVID-19 vaccine; it can reduce the risks of hospitalization, AKI, and ICU admission.
Amaç: COVID-19 tedavisi gören böbrek nakli alıcılarının uzun dönem greft fonksiyonlarını değerlendirmeyi ve hastalığın klinik seyrinde inaktive aşının rolünü araştırmayı amaçladık.Materyal ve Metot: Mart 2020-Eylül 2021 tarihler arasında COVID-19 pnömonisi geçiren böbrek nakli olmuş hastalar çalışmaya dahil edildi.. Aşı olan hastalarda hastalığın klinik seyri değerlendirildi ve aşı olmayanlar ile karşılaştırıldı. Hastaların hastaneye başvuru anı, hastalığı geçirdikten 6 ay ve 12 ay sonraki laboratuvar bilgileri kaydedildi.Bulgular: Çalışmaya COVID-19 enfeksiyonu olan hastaların 56'sı (%67,5) erkek olmak üzere toplam 83 hasta katıldı. Aşıdan sonra 20 hastada COVID-19 hastalığı gelişti. Aşı; akut böbrek hasarı (ABH) gelişimini 5,9 kat ve yoğun bakıma yatışı 1,4 kat azaltmıştır (p<0.05). İzlemde 10 hasta hastaneye ilk başvuruda öldü ve ilk yıl içinde geç ölüm kaydedilmedi. 5 hastaya greft kaybı nedeniyle diyaliz tedavisi başlandı.Sonuç: Böbrek nakli hastalarında COVID-19 enfeksiyonu sonrası greft disfonksiyonu gelişebilir. Bununla birlikte, COVID-19 inaktif aşısı; hastaneye yatış, ABHve yoğun bakıma yatış risklerini azaltabilir.
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