Chronic kidney disease is a key risk factor for severe COVID-19 : A call to action by the ERA-edta
Ortiz, Alberto (Fundacion Jimenez Diaz)
Cozzolino, Mario (University of Milan. Department of Health Sciences Renal Division. ASST Santi Paolo e Carlo)
Duivenvoorden, Raphaël (Department of Nephrology. Radboud University Medical Center)
Fliser, Danilo (Internal Medicine IV. Renal and Hypertensive Disease. University Medical Center)
Fouque, Denis (Department of Nephrology. Dialysis. Nutrition. Centre Hospitalier Lyon Sud)
Franssen, Casper F.M. (Department of Nephrology. University Medical Center Groningen. University Hospital Groningen)
Goumenos, Dimitrios (Department of Nephrology and Renal Transplantation. Patras University Hospital)
Hemmelder, Marc H. (Department of Internal Medicine. Maastricht University Medical Center)
Hilbrands, Luuk B. (Department of Nephrology. Radboud University Medical Center)
Jager, Kitty J. (ERA-EDTA Registry. Dept. Medical Informatics. Amsterdam University Medical Center. Amsterdam Public Health Research Institute)
Massy, Ziad A. (Centre for Research in Epidemiology and Population Health (CESP). INSERM UMRS 1018. UniversitÕ Paris-Saclay. UniversitÕ Versailles Saint Quentin (UVSQ))
Noordzij, Marlies (Department of Nephrology. University Medical Center Groningen. University Hospital Groningen)
Rosenkranz, Alexander R. (Department of Internal Medicine. Division of Nephrology. Medical University of Graz)
Rychlık, Ivan (Department of Internal Medicine. Third Faculty of Medicine. Charles University. Faculty Hospital KrÃlovskÕ Vinohrady)
Soler, Maria Jose (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Stevens, Kate (Glasgow Renal and Transplant Unit. Queen Elizabeth University Hospital)
Torra Balcells, Roser (Institut d'Investigació Biomèdica Sant Pau)
Tuglular, Serhan (Division of Nephrology. Department of Internal Medicine. School of Medicine. Marmara University)
Vart, Priya (University Medical Centre Groningen. University Hospital Groningen)
Wanner, Christoph (University of Würzburg. Division of Nephrology)
Gansevoort, Ron T. (University Medical Center Groningen. Department of Nephrology. University Hospital Groningen)
Universitat Autònoma de Barcelona

Fecha:	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 <30 mL/min/1. 73 m) 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.
Ayudas:	Instituto de Salud Carlos III RD016/0009
Nota:	Altres ajuts: ERA-EDTA; Dutch Kidney Foundation; Baxter and Sandoz; Fondo Europeo de Desarrollo Regional (FEDER).
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Chronic kidney disease ; COVID-19 ; Mortality ; Prevalence ; Renal replacement therapy ; Risk factor
Publicado en:	Nephrology Dialysis Transplantation, Vol. 36 Núm. 1 (2021) , p. 87-94, ISSN 1460-2385

DOI: 10.1093/NDT/GFAA314
PMID: 33340043

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