Chronic kidney disease is a key risk factor for severe COVID-19: a call to action by the ERA-EDTA
Por:
Ortiz, A, Cozzolino, M, Duivenvoorden, R, Fliser, D, Fouque, D, Franssen, CFM, Goumenos, D, Hemmelder, MH, Hilbrands, LB, Jager, KJ, Massy, ZA, Noordzij, M, Rosenkranz, AR, Rychlik, I, Soler, MJ, Stevens, K, Torra, R, Tuglular, S, Vart, P, Wanner, C, Gansevoort, RT, ERA-EDTA Council, Eracoda Working Grp
Publicada:
1 ene 2021
Resumen:
Diabetes, hypertension and cardiovascular disease have been listed as risk factors for severe coronavirus disease 2019 (COVID-19) since the first report of the disease in January 2020. However, this report did not mention chronic kidney disease (CKD) nor did it provide information on the relevance of estimated glomerular filtration rate (eGFR) or albuminuria. As the disease spread across the globe, information on larger populations with greater granularity on risk factors emerged. The recently published OpenSAFELY project analysed factors associated with COVID-19 death in 17 million patients. The picture that arose differs significantly from initial reports. For example, hypertension is not an independent risk factor for COVID-19 death [adjusted hazard ratio (aHR) 0.89], but renal disease very much is. Dialysis (aHR 3.69), organ transplantation (aHR 3.53) and CKD (aHR 2.52 for patients with eGFR<30mL/min/1.73 m(2)) represent three of the four comorbidities associated with the highest mortality risk from COVID-19. The risk associated with CKD Stages 4 and 5 is higher than the risk associated with diabetes mellitus (aHR range 1.31-1.95, depending upon glycaemic control) or chronic heart disease (aHR 1.17). In another recent publication, the Global Burden of Disease collaboration identified that worldwide, CKD is the most prevalent risk factor for severe COVID-19. Moreover, the distribution of risk factors for COVID-19 mortality appears to be different in patients with CKD when compared with the general population. The high prevalence of CKD in combination with the elevated risk of mortality from COVID-19 in CKD necessitates urgent action for this group of patients. This article defines essential action points (summarized in Box 1), among which is advocating the inclusion of CKD patients in clinical trials testing the efficacy of drugs and vaccines to prevent severe COVID-19.
Filiaciones:
Ortiz, A:
Fdn Jimenez Diaz, Dept Nephrol, Madrid, Spain
Cozzolino, M:
Univ Milan, Div Renal, Dept Hlth Sci, ASST Santi Paolo & Carlo, Milan, Italy
Duivenvoorden, R:
Radboud Univ Nijmegen, Dept Nephrol, Med Ctr, Nijmegen, Netherlands
Fliser, D:
Univ Med Ctr, Renal & Hypertens Dis, Internal Med 4, Homburg, Saar, Germany
Fouque, D:
Ctr Hosp Lyon Sud, Dept Nephrol, Dialysis, Nutr, Pierre Benite, France
Franssen, CFM:
Univ Med Ctr Groningen, Univ Groningen Hosp, Dept Nephrol, Groningen, Netherlands
Goumenos, D:
Patras Univ Hosp, Dept Nephrol & Renal Transplantat, Patras, Greece
Hemmelder, MH:
Maastricht Univ, Med Ctr, Dept Internal Med, Maastricht, Netherlands
Hilbrands, LB:
Radboud Univ Nijmegen, Dept Nephrol, Med Ctr, Nijmegen, Netherlands
Jager, KJ:
Amsterdam Univ Med Ctr, Amsterdam Publ Hlth Res Inst, Dept Med Informat, ERA EDTA Registry, Amsterdam, Netherlands
Massy, ZA:
Ambroise ParO Univ Hosp, APHP, Div Nephrol, Boulogne, France
Univ Versailles St Quentin, Univ Paris Saclay, Ctr Res Epidemiol & Populat Hlth CESP, INSERM,UMRS 1018, Villejuif, France
Noordzij, M:
Univ Med Ctr Groningen, Univ Groningen Hosp, Dept Nephrol, Groningen, Netherlands
Rosenkranz, AR:
Med Univ Graz, Div Nephrol, Dept Internal Med, Graz, Austria
Rychlik, I:
Charles Univ Prague, Fac Hosp Kralovsko Vinohrady, Fac Med 3, Dept Internal Med 1, Prague, Czech Republic
Soler, MJ:
Vall dHebron Hosp Univ, Dept Nephrol, Nephrol Res Grp, Vall dHebron Inst Recerca, Vall dHebron Barcelona Hosp Campus, Barcelona, Spain
Stevens, K:
Queen Elizabeth Univ Hosp, Glasgow Renal & Transplant Unit, Glasgow, Lanark, Scotland
Torra, R:
Univ Autonoma Barcelona, Fundacio Puigvert Inst Invest Biomed St Pau, Inherited Kidney Dis Nephrol Dept, Barcelona, Spain
REDINREN, Barcelona, Spain
Tuglular, S:
Marmara Univ, Sch Med, Dept Internal Med, Div Nephrol, Istanbul, Turkey
Vart, P:
Univ Med Ctr Groningen, Univ Groningen Hosp, Dept Nephrol, Groningen, Netherlands
Univ Med Ctr Groningen, Univ Groningen Hosp, Dept Clin Pharm & Pharmacol, Groningen, Netherlands
Wanner, C:
Univ Wurzburg, Div Nephrol, Wurzburg, Germany
Gansevoort, RT:
Univ Med Ctr Groningen, Univ Groningen Hosp, Dept Nephrol, Groningen, Netherlands
hybrid, Green Published
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