Why Covid deaths is higher among patients on kidney dialysis

People with kidney failure who are on dialysis or who have received a kidney transplant face a higher risk of dying from Covid-19 due to differences in their immune system, finds a study.

The team from Universita di Brescia-ASST Spedali Civili di Brescia, Italy, found that these individuals have profound immune system-related differences compared with people with normal kidney function. These differences are further amplified by SARS-CoV-2 infection.

The study included 32 patients who were on dialysis or who received a kidney transplant and were hospitalised for Covid-19, as well as 12 dialysis or transplant patients without Covid-19 and 10 healthy controls.

Patients with a severe Covid-19 course were older and showed lower counts of immune cells called lymphocytes and monocytes, compared with patients with a benign disease course.

Patients without Covid-19 had lower numbers of all major immune cell subsets compared with healthy patients, and these numbers were further reduced in patients with Covid-19, especially in patients with a severe disease course.

"Although dialysis and kidney transplant patients are inherently heterogeneous groups, the immunological abnormalities during Covid-19 are similar across the two cohorts, with the exception of more pronounced defects in innate immunity and a dampened antibody response in kidney transplant patients," said lead author Stefania Affatato, from the varsity.

The findings will be presented online at ASN Kidney Week 2021 November 4-7.

People suffering with severe cases of Covid-19 have shown signs of kidney damage, even those who had no underlying kidney problems before they were infected with the coronavirus.

Early reports say that up to 30 per cent of patients hospitalised with Covid-19 in China and New York developed moderate or severe kidney injury, while reports from doctors in New York said the percentage could be higher.

Signs of kidney problems in patients with Covid-19 include high levels of protein in the urine and abnormal blood work. The kidneys' essential functions have an impact on the heart, lungs and other systems, leading to a serious, and even fatal course of the disease.