The Risk Factors of Poor Outcomes in Chronic Kidney Disease Patients with Coronavirus Disease -19

Abstract

Objective: To analyze the epidemiological and clinical characteristics of COVID-19 in patients with chronic kidney disease (CKD) and identify risk factors predictive of mortality in this population.

Study Design: A retrospective study.

Place and Duration of Study: This study was conducted at the Department of Nephrology, Fatima Memorial Hospital, Lahore from September, 2020 to September, 2021.

Methods: This was a retrospective Study analysis of data collected during the first and second waves of COVID in Lahore, Pakistan. We split the dataset into CKD and Non-CKD Groups after excluding all patients with AKI (including AKI on CKD). Then an extensive descriptive and inferential data analysis was carried out on statistical software R both in-between groups and within-group (CKD).

Results: The study cohort consisted of 454 non-CKD and 121 CKD patients with COVID-19. The mean age was comparable between groups (54.02 ± 15.88 years for non-CKD vs. 51.97 ± 15.32 years for CKD, p=0.29). Males were significantly less likely to present with CKD (OR 0.324, p<0.001). While diabetes mellitus, hypertension, cardiovascular disease, and other comorbidities showed no significant differences, CKD patients exhibited higher total leukocyte counts (TLC) and oxygen requirements at presentation compared to non-CKD patients. Additionally, CKD patients had a significantly higher mortality rate (13.2% vs. 5.7%, p=0.009).

Conclusion: The epidemiology of COVID 19 in patients with CKD in Pakistan is not well defined. A few risk factors of death are described however further efforts are required to elucidate other risk factors.