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Researchers who studied 372 patients admitted to four intensive care units (ICUs) in the United Kingdom found that even those who had less severe kidney disease to start, as well as patients whose kidney disease was caused by the coronavirus, had higher rates of death than those with no kidney disease.
The research, published online recently in the journal Anaesthesia, also indicated that COVID-19 may cause chronic kidney problems in those who do survive.
"Our data demonstrate that kidney disease and failure in critically ill patients with COVID-19 are common and associated with high mortality," wrote a team led by Dr. Sanooj Soni, from Imperial College London.
"However, important differences exist between stages of acute and chronic kidney disease in how they affect mortality in patients with COVID-19, and patients who have had a kidney transplant are an extremely vulnerable group," the authors explained in a journal news release.
"In view of this, attention needs to be paid to COVID-19 patients with any form of kidney disease or injury, and every effort made to prevent progression of this disease or injury to reduce mortality in this cohort of patients," the team added.
The patients in the study had an average age of 60, with 72% of them men and 76% from racial minority groups. About 58% of these ICU patients had kidney impairment.
The researchers found that 21% of those in the ICU with no kidney disease died, compared to nearly half of those with kidney disease. The most vulnerable were patients with kidney transplants, 86% of whom died.
Soni and colleagues suggested that patients on dialysis could be considered for admission to an ICU bed. Limitations to the study included that some of the end-stage kidney failure patients may have been too unwell to be admitted to the ICU, so were not included in the study.
Chronic kidney disease is a decline in kidney function over a period of months or years. More common in older people, it has five stages, including end-stage kidney failure, which must be treated with dialysis or a kidney transplant.
The researchers found that increased mortality could be caused by death of kidney tissue from failure of multiple organs, an immune system response or an inflammation of blood vessels in the kidneys.
-- Cara Roberts Murez
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