Dialysis Requirements of Kidney Transplant Recipients During COVID-19

Objective: The complications of Coronavirus Disease 2019 (COVID-19) have increased among kidney transplant recipients (KTR) due to chronic immunosuppression and comorbidities. Additionally, acute kidney injury (AKI) is frequently observed during COVID-19. This study aimed to investigate the impact of COVID-19 on kidney allograft survival.
Materials and Methods: The retrospective, single-center investigation study included 88 patients who had a functioning kidney allograft prior to COVID-19 diagnosis. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection was confirmed with a polymerase chain reaction (PCR) test and thoracic computerized tomography. AKI and dialysis require-ments were analyzed using laboratory, demographic, and clinical parameters.
Results: The median age of the patients was 44.5 (34.3-53.8) years, and the median allograft survival was 59.0 (20.8-116.5) months. The mean baseline estimated glomerular filtration rate (eGFR) was 58.2 (21.2-92.8) ml/min/1.73 m2 before the COVID-19 diagnosis. The frequency of AKI was 70.4% (62 patients), and dialysis therapy was required in nine patients (10.2%). The clinical features of COVID-19 and inflammatory markers had no statistical significance in predicting dialysis requirements. However, logistic regression analysis indicated that serum protein level (p=0.034), serum albumin level (p=0.048), hemoglobin (p=0.028), baseline eGFR (p=0.033), and age (p=0.041) were significantly predictive for dialysis requirements.
Conclusion: Age, anemia, and decreased baseline eGFR are related to severe AKI and dialysis therapy in KTR during COVID-19.