COVID-19 patients with chronic kidney disease at highest risk of death

A large, international study of COVID-19 patients has confirmed that chronic kidney disease may increase a patient's risk of death by three times.

Nobody is safe from the COVID-19 virus, but some groups may suffer more. Available data suggest that people with pre-existing health conditions like cardiovascular disease, hypertension, diabetes, congestive heart failure, chronic kidney disease, stroke, and cancer are more prone to become severely ill once they get infected with the virus. People with these chronic conditions are also at higher risk of death from the COVID-19.

A large, international study of COVID-19 patients has also confirmed that these pre-existing conditions may increase a patient's risk of death by one-and-a-half to three times. Conducted by Penn State College of Medicine researcher, the study results were recently published in PLOS ONE.

The researchers found that cardiovascular disease may double a patient's risk of dying from COVID-19. The results were recently published in PLOS ONE.

Chronic kidney disease and COVID-19 complications

Based on their findings, the authors of the study suggested that the presence of these chronic health conditions in patients with COVID-19 is a warning sign of a higher risk of death.

The research team came to the conclusion after conducting a systematic review and meta-analysis of studies published from December 2019 through early July 2020. They explored 11 co-existing conditions that pose a risk of severe disease and death among COVID-19 patients. These include cardiovascular disease, diabetes, high blood pressure, cancer, chronic kidney disease, chronic obstructive pulmonary disease, stroke, congestive heart failure, asthma, chronic liver disease, and HIV/AIDS.

After analyzing data from over 65,000 patients from 25 studies worldwide, the researchers found that certain pre-existing health conditions affected survival rates more than others.

It was found that hospitalized COVID-19 patients with diabetes and cancer were 1.5 times more likely to die as compared to those patients without pre-existing conditions. While patients with cardiovascular disease, hypertension and congestive heart failure were twice as likely to die, the death risk was three times higher in patients with chronic kidney disease.

Why kidney patients face severe COVID-19 outcomes?

The main function of the kidneys is to filter wastes and excess fluids from your blood, which are then excreted in the urine. When this function is impaired, dangerous levels of fluid, electrolytes, and wastes can build up in your body. This can progress to end-stage kidney failure, which is fatal.

Kidney disease does not put patients at higher risk of contracting COVID-19. But they are at risk for more severe outcomes during infection.

While it is not clear why patients with kidney disease are more at risk for severe COVID-19, some experts suggest it may be because these patients are typically older and have other chronic illnesses such as diabetes that are risk factors for severe COVID-19. Additionally, patients with kidney disease may also have a weakened immune system.

Some hospitalized COVID-19 patients develop acute kidney injury (AKI) a sudden decline in kidney function even if they have never had kidney disease before. This condition is more common in patients who become critically ill and need intensive care. In most cases, acute kidney injury may require emergency dialysis.

How COVID-19 affects the kidneys? One possible reason is that the ACE2 receptor that binds with the SAR-CoV2 viral spike is abundant throughout the human body, including the kidneys. Kidney biopsies have shown the presence of tiny blood clots in COVID-19 patients. These blood clots can affect the proper functioning of the kidneys.