scholarly journals COVID-19 in Children with Chronic Dialysis and Kidney Transplantation

2021 ◽  
Author(s):  
Nur Canpolat ◽  
Zeynep Yürük Yıldırım ◽  
Nurdan Yıldız ◽  
Mehmet Taşdemir ◽  
Nilüfer Göknar ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Severe Disease ◽  
Pediatric Nephrology ◽  
Kidney Injury ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Multicenter Observational Study ◽  
Entire Cohort ◽  
Mild Disease ◽  
Increased Risk

Abstract The aim of the study is to present incidence of COVID-19 in children with renal replacement therapy (RRT) and compare the severity and outcomes of the disease between the groups undergoing dialysis and kidney transplantation (KTx). This multicenter observational study was based on data collected from children receiving RRT, either chronic dialysis or KTx, diagnosed with COVID-19. All members of the Istanbul branch of the Turkish Pediatric Nephrology Association were requested to submit all their confirmed COVID-19 cases between April 1 and December 31, 2020. They were also asked to report the number of their prevalent patients on RRT under the age of 20. A total of 46 RRT patients diagnosed with COVID-19 were reported from 12 centers. Of these, 29 were KTx recipients, and 17 were on dialysis. COVID-19 cases represented 9.3% of all prevalent dialysis patients and 9.2% of all prevalent KTx recipients. Twelve KTx recipients (41.4%) and three dialysis patients (17.6%) were asymptomatic (p = 0.12). The hospitalization rate was higher in dialysis patients than KTx recipients (82.4% vs. 27.6%, p = 0.001). Two patients, one in each group, experienced a severe disease course, and only one hemodialysis patient had a critical illness that required mechanical ventilation. Acute kidney injury developed in 36% of KTx recipients, but none required dialysis or lost their graft. In the entire cohort, one patient on hemodialysis with multiple comorbidities died.Conclusion: Although most of cases were asymptomatic or had a mild disease, children on RRT seem to have an increased risk for COVID-19.

Reduced risk of new onset stroke after kidney transplantation in Asian dialysis patients: a propensity score-matched, competing risk study in Taiwan

QJM ◽  
2019 ◽  
Vol 112 (7) ◽  
pp. 489-495 ◽  
Author(s):  
S -F Weng ◽  
Y -C Shen ◽  
J -J Wang ◽  
K -J Tien
Keyword(s):  
Kidney Transplantation ◽  
Incidence Rates ◽  
Chronic Dialysis ◽  
Rank Test ◽  
Birth Date ◽  
Dialysis Patients ◽  
Cerebrovascular Events ◽  
Increased Risk ◽  
Reduced Risk ◽  
New Onset

Abstract Background Kidney transplantation (KT) has been found to reduce cardiovascular events and mortality in chronic dialysis patients. There is little data, however, regarding the risk reduction of cerebrovascular events after KT in Asian populations. This study evaluates the risk of cerebrovascular events after KT in Taiwan. Methods Tapping Taiwan’s National Health Insurance claims data of patients with a diagnosis of end-stage renal disease (ESRD), we enrolled all KT recipients from 1999 to 2011 (n = 2908). For each KT patient, four controls (patients also diagnosed with ESRD) without KT were propensity matched by birth date, sex, selected comorbidities and duration of dialysis. All subjects were followed to the end of 2011. Results The incidence rate for stroke in the KT recipients and comparison group were 52.63 and 137.26 per 10 000 person-years, respectively. After adjustment for age, gender and comorbidities with competing mortality, KT recipients had 60% reduction in all kinds of stroke, compared to those who did not receive procedure. They were found to have a 48 and 74% reduction in ischemic and hemorrhagic stroke risk, respectively. Subgroup analyses also showed similar trends in the improvement of stroke after KT. While elderly patients, men, and those with diabetes, hypertension and coronary artery disease are at increased risk for stroke, our log-rank test revealed those that received KT had significantly lower cumulative incidence rates of stroke than those that did not (P < 0.001). Conclusions KT was associated with reduced risk of new onset stroke in chronic dialysis patients in Taiwan.

scholarly journals COVID-19—Importance for Patients on the Waiting List and after Kidney Transplantation—A Single Center Evaluation in 2020–2021

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 429
Author(s):  
Simone C. Boedecker ◽  
Pascal Klimpke ◽  
Daniel Kraus ◽  
Stefan Runkel ◽  
Peter R. Galle ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Waiting List ◽  
Smoking History ◽  
Immunocompromised Patients ◽  
Dialysis Patients ◽  
Vaccination Programs ◽  
Mild Disease ◽  
Probability Of Survival ◽  
Number Of Patients ◽  
Immunosuppressed Patients

(1) Background: Dialysis patients and recipients of a kidney allograft are at high risk for infection with SARS-CoV-2. It has been shown that the development of potent neutralizing humoral immunity against SARS CoV-2 leads to an increased probability of survival. However, the question of whether immunocompromised patients develop antibodies has not yet been sufficiently investigated; (2) Methods: SARS-CoV-2 antibodies were examined in hemodialysis patients on the waiting list for kidney transplantation as well as patients after kidney transplantation. Patients were interviewed about symptoms and comorbidities, BMI, and smoking history; (3) Results: SARS-CoV-2 antibodies were found in 16 out of 259 patients (6%). The trend of infections here reflects the general course of infection in Germany with a peak in November/December of 2020. Remarkably, patients on the waiting list experienced only mild disease. In contrast, transplanted patients had to be hospitalized but recovered rapidly from COVID-19. Most interesting is that all immunosuppressed patients developed antibodies against SARS-CoV-2 after infection; (4) Conclusions: Even with extensive hygiene concepts, an above-average number of patients were infected with SARS-CoV-2 during the second wave of infections in Germany. Because SARS-CoV-2 infection triggered the formation of antibodies even in these immunocompromised patients, we expect vaccination to be effective in this group of patients. Thus, dialysis patients and patients after kidney transplantation should be given high priority in vaccination programs.

scholarly journals Increased risk of cancer in chronic dialysis patients: a population-based cohort study in Taiwan

2011 ◽  
Vol 27 (4) ◽  
pp. 1585-1590 ◽  
Author(s):  
H.-F. Lin ◽  
Y.-H. Li ◽  
C.-H. Wang ◽  
C.-L. Chou ◽  
D.-J. Kuo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Increased Risk ◽  
Risk Of Cancer

scholarly journals P525 Patients’ Perception of Risks of biologic therapy During Covid-19 Pandemic in Israel Orly Lior, Ilia Sergeev, Nahum Ruhimovich, Michal Openheim, Fabiana Benjaminov, Dan Feldman, Yehuda Ringel, Timna Naftali Division of Gastroenterology and Liver Diseases, Meir Medical Center, Kfar Saba, Israel

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S501-S501
Author(s):  
O Lior ◽  
I Sergeev ◽  
N Ruhimovich ◽  
M Openheim ◽  
F Benjaminov ◽  
...  
Keyword(s):  
Medical Center ◽  
Severe Disease ◽  
Treatment Decision ◽  
Mild Disease ◽  
Treatment Decision Making ◽  
Increased Risk ◽  
Increase Risk ◽  
History Of ◽  
Stopping Treatment ◽  
Theoretical Question

Abstract Background Current inflammatory bowel disease (IBD) therapies are highly effective. However, compliance with treatment is influenced by patients’ perception of benefits versus risks. Understanding these perceptions and their influence on patients’ treatment decision-making is crucial for achieving compliance, especially during Covid-19 pandemic. Aim: to assess patients’ perception of risks of IBD exacerbation and SARS-CoV-2 infection, and their influence on patients’ decisions regarding biologic and immunosuppressive treatments during Covid-19 pandemic in Israel. Methods A prospective internet-based survey among Meir Medical Center, IBD clinic patients. Results 116 patients have responded. Mean age 42 (18–84), 44 (38%) males, 75 (64%) Crohn’s disease, 38 (32%) ulcerative colitis, 34 (29%) with history of abdominal surgery, 47 (40%) were in remission and 9(7.5%) with severe disease. 18 (15%) patients were on Immunosuppressive and 76 (66%) on biologic treatments. Concerns of contracting SARS-CoV-2 infection: 56 (48%) patients considered their risk as equal to that of the general population whereas 53 (46%) considered it to be increased. 55% of the patients related the increase risk of COVID-19 infection to their IBD treatment, whereas 47% related it to having IBD. Patients treated with biologics were more concerned of becoming infected with SARS-CoV-2 then those who were not. There was also a significant association between depression and anxiety levels and the fear of becoming infected (r= 0.3 for depression and 0.4 for anxiety). Adherence to IBD treatment: Only 8 (7.5%) patients considered stopping their IBD treatment, and only 4 (3.7%) patients actually stopped their treatment. Patients with more severe disease were more inclined to stop their treatment compared to those with mild disease. Reasons for not stopping treatment were fear of disease exacerbation in 37 (32%) patients, and reassuring information received from medical providers, in 25 (21.5%) patients. When faced with a theoretical question of trading long-term remission versus risk of SARS-CoV-2infection, 34 (29%) patients were willing to accept a 10% infection risk for a 10-year remission Conclusion Significant portion of the patients with IBD believe that they are at increased risk of contracting SARS-CoV-2 infection, and more than half of them related the increase risk to their IBD treatment. However, despite their fear most patients felt safe enough to continue their treatment. Patients with more severe disease and treated with biologics experienced higher levels of anxiety, depression and fear of COVID-19 infection. Identifying and addressing these fears early might increase patient’s adherence to treatment and prevent the hazardous effects of discontinuation of treatment.

Reasons for Refusing Kidney Transplantation Among Chronic Dialysis Patients

2013 ◽  
Vol 17 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Tea Nizič-Kos ◽  
Anja Ponikvar ◽  
Jadranka Buturović-Ponikvar
Keyword(s):  
Kidney Transplantation ◽  
Chronic Dialysis ◽  
Dialysis Patients

scholarly journals MO359ASSOCIATIONS BETWEEN RENAL FUNCTION TRAJECTORIES AFTER 3 MONTHS ACUTE KIDNEY INJURY AND LONG-TERM RENAL OUTCOMES

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Chien-Ning Hsu ◽  
You-Lin Tain
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Injury ◽  
Chronic Dialysis ◽  
Dialysis Initiation ◽  
Renal Recovery ◽  
Post Discharge ◽  
Renal Function Recovery ◽  
Increased Risk ◽  
Function Recovery

Abstract Background and Aims Renal function recovery after acute kidney injury (AKI) is associated with patient outcomes. The study objectives were to assess the patterns of AKI recovery within 6 months following discharge for AKI and subsequent incidence of chronic dialysis. Method A retrospective cohort of 234,867 hospitalized adult patients was examined for AKI between January 1, 2010, and December 31, 2017 in the largest healthcare delivery system in Taiwan. Renal function recovery at 3- and 6-month post discharge, incident chronic kidney disease and chronic dialysis initiation were analyzed over 7 years of follow-up. Renal recovery was defined by &lt; 1.5× baseline SCr (prior to the hospitalization). Independent associations between renal function recovery patterns and renal outcomes was assessed by Cox proportional hazard model controlling for potential confounders, and subdistribution hazard ratio (SHR) with [95% CI] was analysed for competing risk of early death. Results Among 3 months AKI survivors (n=24,132), 14.28% (n=3,430) did not recovery back to baseline, and 16% of recovery did not sustain. Three distinct renal function recovery continuums at 6 months post hospital discharge were: persistent non-recovery (10.18%), non-recovery (14.33%), and recovery (75.5%). Comparing to survivors without AKI (n=50,387), the impact of renal recovery continuum on chronic dialysis initiation varied by patient’s baseline renal disease (SHR was 2.82 [95%CI, 2.42-3.28] in CKD, and 0.8 [95%CI, 0.27-2.38] for non-CKD. Persistent non-recovery was significantly associated with a greater increased risk of chronic dialysis than non-recovery in any patients with AKI. Comparing to patients with sustained AKI recovery, risk of CKD onset increased 5-fold in persistent non-recovery and 3-fold risk in non-recovery. Conclusion The continuum of AKI recovery post 6 months is associated with increased risk of chronic dialysis, particularly in patients with baseline CKD. These study results suggested that patients ever with AKI should receive close renal function monitoring for post-discharge management.

Increased Risk of Cardiovascular Disease with Erythropoietin in Chronic Dialysis Patients

Nephron ◽  
1996 ◽  
Vol 72 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Kunitoshi Iseki ◽  
Keizo Nishime ◽  
Hajime Uehara ◽  
Kiyoyuki Tokuyama ◽  
Shigeki Toma ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Increased Risk

scholarly journals Acute Kidney Injury and Long-Term Risk for Cardiovascular Events in Patients after Kidney Transplantation

2019 ◽  
Vol 44 (5) ◽  
pp. 1149-1157
Author(s):  
Ruth Rahamimov ◽  
Tuvia Y. van Dijk ◽  
Maya Molcho ◽  
Itay Vahav ◽  
Eytan Mor ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Cardiovascular Events ◽  
Kidney Injury ◽  
Time Varying ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Cv Disease

Background: Acute kidney injury (AKI) was found to be associated with an increased risk of major adverse cardiovascular events (MACE) in the general population. Patients after kidney transplantation are prone to AKI events and are also at an increased risk of cardiovascular (CV) disease. The association between AKI and MACE in kidney transplant patients is yet to be studied. Methods: This retrospective single-center cohort study reviewed 416 adult renal allograft recipients transplanted between 2005 and 2010. AKI events were recorded starting 2 weeks after transplantation, or following discharge with a functioning graft. AKI was defined, according to the KDIGO criteria. The primary outcome was the composite of MACE starting 6 months after transplantation and all-cause mortality. For survival analysis, we used univariate and multivariate time varying Cox proportional hazard model. Results: One hundred and twenty-four patients (29.8%) had at least one episode of AKI. During the median follow-up time of 7.2 years (interquartile range 4.3–9.1), 144 outcome events occurred. By time varying Cox regression analysis, AKI was associated with an increased rate of CV outcomes or death (hazard ratio [HR] 1.96, 95% CI 1.36–2.81, p < 0.001), and the association remained significant by multivariate adjusted model (HR 1.76, 95% CI 1.18–2.63, p = 0.005). As for the different components of MACE, all-cause mortality and CV mortality were the only outcomes that were significantly associated with AKI. No interaction between AKI timing and MACE was found. Conclusion: AKI in kidney transplant recipient is associated with an increased risk of CV disease.

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