End-stage renal disease (ESRD), also called end-stage kidney disease (ESKD), occurs when chronic kidney disease (CKD) – the gradual loss of kidney function – reaches an advanced state.
In ESKD, the kidneys are no longer able to work as they should to meet your body’s needs. The kidneys filter wastes and excess fluids from the blood, which are then excreted in the urine. When the kidneys lose their filtering capabilities, dangerous levels of fluid, electrolytes and wastes can build up in the body.
COVID-19 hospitalization and all-cause death rates for patients with end-stage kidney disease undergoing dialysis, as well as kidney transplant recipients, climbed steeply early in the pandemic, and both exhibited racial disparities, according to a study published in the Journal of the American Society of Nephrology (JASN).
Researchers at Hennepin Healthcare Research Institute (HHR) in Minneapolis, Minnesota retrospectively analyzed data from the Centers for Medicare & Medicaid Services Renal Management Information System before and after the emergence of COVID-19.
The HHRI investigators found that when the hospitalization rate for COVID-19 patients undergoing dialysis peaked from March 22 to April 25, 2020, it was 40 times higher than that of the rest of the population. And the risk of death from any cause was 17% higher among those on dialysis and 30% higher among kidney transplant recipients from Mar 22 to Jul 4, 2020, than during corresponding periods in 2017 to 2019.
Black and Hispanic patients had particularly high hospitalization rates, while those undergoing at-home dialysis had lower rates than those receiving their treatments in clinics. Dialysis patients were also hospitalized 17% less often than usual for reasons other than coronavirus during the pandemic.
The authors noted that roughly 800,000 people on dialysis or living with a kidney transplant in the United States are at higher risk for COVID-19 because many visit clinics multiple times each week for dialysis or, in the case of transplant recipients, take drugs to prevent organ rejection that make them susceptible to infection.
Kidney diseases, especially ESRD, are already the 7th leading cause of death among the Filipinos. One Filipino develops chronic renal failure every hour or about 120 Filipinos per million population per year. More than 5,000 Filipino patients are presently undergoing dialysis and approximately 1.1 million people worldwide are on renal replacement therapy. The benefits of the COVID vaccine for people with chronic kidney disease at any stage, those on dialysis, and kidney transplant recipients are much greater than the risk of serious disease or complications from COVID-19. It is important for people with CKD to discuss with his or her doctor about getting a COVID-19 vaccine.
Dr. Melvin Sanicas (@Vaccinologist) is a physician-scientist specializing in vaccines, infectious diseases, and global health.