Kidney dialysis and kidney transplant patients infected with the coronavirus are more prone to serious complications and have a higher risk of death. This is part of the first results of research by UMCG, Radboudumc and Amsterdam UMC, led by Ron Gansevoort, professor of Nephrology (UMCG).
Because so little was known about COVID-19, doctors from the university medical centers in Groningen, Nijmegen and Amsterdam decided to set up a database in March. They asked colleagues from all over Europe to enter data from their patients who, in addition to their kidney disease, also had COVID-19, in the database. They wanted to know what the consequences of COVID-19 are for kidney patients. How is their illness and recovery going and what treatment options are there? Based on this, kidney patients with a corona infection can be treated better and better substantiated choices can be made, for example about IC admission.
The database of the so-called ERACODA study now contains data from more than 1,600 patients from 28 European countries. “When the hospitals were overcrowded with COVID patients, we saw that dialysis patients were not always admitted to intensive care. It seemed that doctors thought they would not survive that, ”says projectleader Gansevoort. “It is important to make these kinds of decisions based on facts instead of prejudices. And that there will be a general, substantiated policy, so that not everyone decides for themselves which patient is admitted to intensive care and which is not. Ultimately, the goal is to provide doctors with better leads for the treatment of this specific group of patients. ”
The first results show that the death rate from COVID-19 among dialysis and kidney transplant patients is high, even higher than for the known high-risk patients, such as patients with heart failure or lung diseases. “It is also remarkable that in dialysis and kidney transplant patients it makes no difference whether you are a man, or have diabetes, high blood pressure or cardiovascular disease. These factors must therefore not be taken into account in order to have a dialysis or transplant patient admitted to an IC or not. ”
Start research without funding
When the number of coronavirus infections in the Netherlands, as in the rest of Europe, increased rapidly in March, the researchers felt a great urgency to investigate the consequences of COVID-19 for their specific patients. They decided not to wait until they found funding for their researchproposal, but to start setting up the database immediately. Due to the great relevance of this project, the dutch ‘Nierstichting’ (Kidney Foundation) has promised to raise additional funds especially for this research.
ERACODA (the European Renal Association COVID-19 Database) is a collaboration between UMC Groningen, Radboudumc Nijmegen, Amsterdam UMC and Nefrovisie. In this European project, detailed data is collected from people with renal replacement therapy (dialysis or transplantation) who received corona. Information is collected on many different patient characteristics (such as age, gender, type of kidney disease and medication use), as well as on COVID-19 characteristics (symptoms such as blood pressure and temperature, and laboratory results). Each patient is also given a score for how fit or vulnerable someone is. This score can affect the chance of being admitted to the hospital or intensive care unit. Finally, ERACODA examines the impact of the current epidemic on the quality of life of patients. The research is financially supported by the Kidney Foundation, the European professional association for kidney specialists (ERA-EDTA) and various medical companies. Visit www.eracoda.org for more background information on the research.