Erratum to: COVID-19-related mortality in kidney transplant and dialysis patients: results of the ERACODA collaboration

Abstract Background. Patients on kidney replacement therapy comprise a vulnerable population and may be at increased risk of death from coronavirus disease 2019 (COVID-19). Currently, only limited data are available on outcomes in this patient population. Methods. We set up the ERACODA (European Renal Association COVID-19 Database) database, which is specifically designed to prospectively collect detailed data on kidney transplant and dialysis patients with COVID-19. For this analysis, patients were included who presented between 1 February and 1 May 2020 and had complete information available on the primary outcome parameter, 28-day mortality. Results. Of the 1073 patients enrolled, 305 (28%) were kidney transplant and 768 (72%) dialysis patients with a mean age of 60 ± 13 and 67 ± 14 years, respectively. The 28-day probability of death was 21.3% [95% confidence interval (95% CI) 14.3–30.2%] in kidney transplant and 25.0% (95% CI 20.2–30.0%) in dialysis patients. Mortality was primarily associated with advanced age in kidney transplant patients, and with age and frailty in dialysis patients. After adjusting for sex, age and frailty, in-hospital mortality did not significantly differ between transplant and dialysis patients [hazard ratio (HR) 0.81, 95% CI 0.59–1.10, P = 0.18]. In the subset of dialysis patients who were a candidate for transplantation (n = 148), 8 patients died within 28 days, as compared with 7 deaths in 23 patients who underwent a kidney transplantation <1 year before presentation (HR adjusted for sex, age and frailty 0.20, 95% CI 0.07–0.56, P < 0.01). Conclusions. The 28-day case-fatality rate is high in patients on kidney replacement therapy with COVID-19 and is primarily driven by the risk factors age and frailty. Furthermore, in the first year after kidney transplantation, patients may be at increased risk of COVID-19-related mortality as compared with dialysis patients on the waiting list for transplantation. This information is important in guiding clinical decision-making, and for informing the public and healthcare authorities on the COVID-19-related mortality risk in kidney transplant and dialysis patients.

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Willingness to change diet and exercise behavior is associated with better lifestyle in dialysis patients close to a kidney transplant

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2021.11.032 ◽

2021 ◽

Author(s):

Claudia N. Orozco-González ◽

Laura Cortés-Sanabria ◽

Roxana M. Marquez-Herrera ◽

Fabiola Martín-del-Campo ◽

Erika F. Gómez-García ◽

...

Keyword(s):

Kidney Transplant ◽

Exercise Behavior ◽

Dialysis Patients ◽

Diet And Exercise ◽

Willingness To Change

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Employment of Patients With Kidney Failure Treated With Dialysis or Kidney Transplantation - A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-147522/v1 ◽

2021 ◽

Author(s):

Lilli Kirkeskov ◽

Rasmus Carlsen ◽

Thomas Lund ◽

Niels-Henrik Buus

Keyword(s):

Systematic Review ◽

Kidney Transplantation ◽

Kidney Transplant ◽

Kidney Failure ◽

Educational Level ◽

Meta Analysis ◽

Cochrane Library ◽

Employment Rate ◽

Dialysis Patients ◽

Post Transplant

Abstract Background: Patients with kidney failure treated with dialysis or kidney transplantation experience difficulties maintaining employment due to the condition itself as well as the treatment. We aimed to establish the rate of employment before and after initiation of dialysis and after kidney transplantation and to identify predictors of employment during dialysis and post-transplant.Methods: This systematic review and meta-analysis was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis, PRISMA, for studies that included employment rate in adults receiving dialysis or a kidney transplant. The literature search included cross sectional or cohort studies published in English in the period from January 1966 to August 2020 in the databases PubMed, Embase, and Cochrane Library. Data of employment rate, study population, age, gender, educational level, dialysis duration, kidney donor, ethnicity, dialysis modality, waiting time for transplantation, diabetes, and depression were extracted. Quality assessment was performed using the Newcastle-Ottawa Scale. Meta-analysis for predictors for employment and odds ratio; confidence intervals; and test for heterogeneity were calculated using Chi-squared statistics and I2. PROSPERO registration number: CRD42020188853.Results. 33 studies with 162,059 participants during dialysis and 31 studies with 137,742 participants receiving kidney transplantation. Dialysis patients were on average 52.6 years old (range 16-79), 60.3% males and kidney transplant patients 46.7 years old (range 18-78), 59.8% males. The employment rate (weighted mean) for dialysis patients was 26.3% (range 10.5-59.7%); pre-transplant 36.9% (range 25-86%), and post-transplant 38.2% (range 14.2-85%). Predictors for employment during dialysis and post-transplant were male, non-diabetic, peritoneal dialysis, and higher educational level, and post-transplant: pre-transplant employment, younger age, transplantation with a living donor kidney, and without depression.Conclusions: Patients with kidney failure had a low employment rate during dialysis, pre- and post-transplant. Kidney failure patients should be supported through a combination of clinical and social measures to ensure they remain in work.

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Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe

Kidney International ◽

10.1016/j.kint.2020.09.006 ◽

2020 ◽

Vol 98 (6) ◽

pp. 1540-1548 ◽

Cited By ~ 14

Author(s):

Kitty J. Jager ◽

Anneke Kramer ◽

Nicholas C. Chesnaye ◽

Cécile Couchoud ◽

J. Emilio Sánchez-Álvarez ◽

...

Keyword(s):

Kidney Transplant ◽

High Mortality ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Dialysis Patients

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Multidisciplinary Approach To Chronic Kidney Disease Complications: A Cross-Sectional Comparative Analysis Between Kidney Transplant Recipients and Pre-Dialysis Patients.

Transplantation Journal ◽

10.1097/00007890-201407151-01589 ◽

2014 ◽

Vol 98 ◽

pp. 477

Author(s):

H. Sanders-Pinheiro ◽

M. Carminatti ◽

N. Fernandes ◽

F. Colugnati ◽

M. Bastos

Keyword(s):

Chronic Kidney Disease ◽

Comparative Analysis ◽

Kidney Disease ◽

Kidney Transplant ◽

Multidisciplinary Approach ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Dialysis Patients ◽

Cross Sectional

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Infection-Related Mortality in Recipients of a Kidney Transplant in Australia and New Zealand

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.03200319 ◽

2019 ◽

Vol 14 (10) ◽

pp. 1484-1492 ◽

Cited By ~ 7

Author(s):

Samuel Chan ◽

Elaine M. Pascoe ◽

Philip A. Clayton ◽

Stephen P. McDonald ◽

Wai H. Lim ◽

...

Keyword(s):

New Zealand ◽

T Cell ◽

General Population ◽

Kidney Transplant ◽

Older Age ◽

Competing Risk ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Female Sex ◽

Related Mortality

Background and objectivesThe burden of infectious disease is high among kidney transplant recipients because of concomitant immunosuppression. In this study the incidence of infectious-related mortality and associated factors were evaluated.Design, setting, participants, & measurementsIn this registry-based retrospective, longitudinal cohort study, recipients of a first kidney transplant in Australia and New Zealand between 1997 and 2015 were included. Cumulative incidence of infectious-related mortality was estimated using competing risk regression (using noninfectious mortality as a competing risk event), and compared with age-matched, populated-based data using standardized incidence ratios.ResultsAmong 12,519 patients, (median age 46 years, 63% men, 15% diabetic, 6% Indigenous ethnicity), 2197 (18%) died, of whom 416 (19%) died from infection. The incidence of infection-related mortality during the study period (1997–2015) was 45.8 (95% confidence interval [95% CI], 41.6 to 50.4) per 10,000 patient-years. The incidence of infection-related mortality reduced from 53.1 (95% CI, 45.0 to 62.5) per 10,000 person-years in 1997–2000 to 43.9 (95% CI, 32.5 to 59.1) per 10,000 person-years in 2011–2015 (P<0.001) Compared with the age-matched general population, kidney transplant recipients had a markedly higher risk of infectious-related death (standardized incidence ratio, 7.8; 95% CI, 7.1 to 8.6). Infectious mortality was associated with older age (≥60 years adjusted subdistribution hazard ratio [SHR], 4.16; 95% CI, 2.15 to 8.05; reference 20–30 years), female sex (SHR, 1.62; 95% CI, 1.19 to 2.29), Indigenous ethnicity (SHR, 2.87; 95% CI, 1.84 to 4.46; reference white), earlier transplant era (2011–2015: SHR, 0.39; 95% CI, 0.20 to 0.76; reference 1997–2000), and use of T cell–depleting therapy (SHR, 2.43; 95% CI, 1.36 to 4.33). Live donor transplantation was associated with lower risk of infection-related mortality (SHR, 0.53; 95% CI, 0.37 to 0.76).ConclusionsInfection-related mortality in kidney transplant recipients is significantly higher than the general population, but has reduced over time. Risk factors include older age, female sex, Indigenous ethnicity, T cell–depleting therapy, and deceased donor transplantation.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2019_08_27_CJN03200319.mp3

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Multicentre registry data analysis comparing outcomes of culture-negative peritonitis and different subtypes of culture-positive peritonitis in peritoneal dialysis patients

Peritoneal Dialysis International ◽

10.1177/0896860819879891 ◽

2020 ◽

Vol 40 (1) ◽

pp. 47-56 ◽

Cited By ~ 1

Author(s):

Htay Htay ◽

Yeoungjee Cho ◽

Elaine M Pascoe ◽

Carmel Hawley ◽

Philip A Clayton ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Primary Outcome ◽

Catheter Removal ◽

Dialysis Patients ◽

Gram Positive ◽

Pseudomonas Species ◽

Gram Negative Organisms ◽

Culture Positive ◽

Culture Negative ◽

Related Mortality

Background: The outcomes of culture-negative peritonitis in peritoneal dialysis (PD) patients have been reported to be superior to those of culture-positive peritonitis. The current study aimed to examine whether this observation also applied to different subtypes of culture-positive peritonitis. Methods: This multicentre registry study included all episodes of peritonitis in adult PD patients in Australia between 2004 and 2014. The primary outcome was medical cure. Secondary outcomes were catheter removal, hemodialysis transfer, relapsing/recurrent peritonitis and peritonitis-related death. These outcomes were analyzed using mixed effects logistic regression. Results: Overall, 11,122 episodes of peritonitis occurring in 5367 patients were included. A total of 1760 (16%) episodes were culture-negative, of which 77% were medically cured. Compared with culture-negative peritonitis, the odds of medical cure were lower in peritonitis caused by Staphylococcus aureus (adjusted odds ratio (OR) 0.62, 95% confidence interval (CI) 0.52–0.73), Pseudomonas species (OR 0.20, 95% CI 0.16–0.26), other gram-negative organisms (OR 0.48, 95% CI 0.41–0.56), polymicrobial organisms (OR 0.30, 95% CI 0.25–0.35), fungi (OR 0.02, 95% CI 0.01–0.03), and other organisms (OR 0.61, 95% CI 0.49–0.76), while the odds were similar in other (non-staphylococcal) gram-positive organisms (OR 1.11, 95% CI 0.97–1.28). Similar results were observed for catheter removal and hemodialysis transfer. Compared with culture-negative peritonitis, peritonitis-related mortality was significantly higher in culture-positive peritonitis except that due to other gram-positive organisms. There was no difference in the odds of relapsing/recurrent peritonitis between culture-negative and culture-positive peritonitis. Conclusion: Culture-negative peritonitis had superior outcomes compared to culture-positive peritonitis except for non-staphylococcal gram-positive peritonitis.

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