Nav: Home

Are kidney transplant patients at higher risk? The European experience

June 05, 2020

Experience throughout the world, including in Europe, shows that advanced age is the most important risk factor for death in COVID-19: people aged over 70 years are over 10 times more likely to die compared to those aged below 50. Other factors increasing the risk of death include male sex and comorbidities, including obesity, hypertension, cardiovascular disease, diabetes, chronic lung disease and cancer.

Until now, data on COVID-19 in kidney transplant patients have been limited. In response to the pandemic, ERACODA was established as a European database to investigate COVID-19 outcomes in patients with kidney failure. ERACODA is now the largest international database with detailed follow-up, and unlike some other databases, contains data on kidney transplant as well as dialysis patients.

"There are several reasons why kidney transplant patients could be at higher risk. Not only do they often have known risk factors for severe COVID-19, but they also take daily immunosuppressive drugs that impair their immune response," said Professor Luuk Hilbrands. "At the same time, these patients know that they are vulnerable, and must protect themselves from infection and seek medical help for fever or other symptoms. Immunosuppressive drugs may also reduce the hyperinflammatory response in severe COVID-19, and some immunosuppressants (for example, cyclosporine) inhibit corona virus replication in the laboratory." Professor Hilbrands was speaking at the press conference held during the run-up to the ERA-EDTA Congress.

By June 1st, a total of 1073 patients with COVID-19 and complete 28-day follow-up had been entered on to the ERACODA database by 197 physicians from 98 centres in 26 countries, mainly in Europe. Of patients included on the database, 305 (28%) were kidney transplant recipients. By 28 days, 21% of these patients had died--a case fatality rate only slightly lower than the 25% case fatality rate seen in dialysis patients. In patients managed outside the hospital, mortality was low at 3% of kidney transplant patients compared to 5% of dialysis patients. Following admission to hospital, 24% of transplant patients died compared to 33% of dialysis patients. Of those treated in the intensive care unit (ICU), 45% of kidney transplant patients died compared with 53% of dialysis patients.

As in the general population, age over 75 years was the most important risk factor for death in kidney transplant patients, but male sex, diabetes and cardiovascular disease were not associated with mortality risk. There was also no evidence of benefit from treatment with antiviral drugs, or reduction or withdrawal of immunosuppressive therapy.

Professor Hilbrands commented: "With longer-term follow-up, we will be able to evaluate the consequences of COVID-19 for long-term kidney graft function. In the meantime, younger, relatively healthy kidney transplant patients do not seem to be at particular risk of death as long as they strictly follow social distancing and hygiene rules. However, risk is individual, and I strongly advise all patients to talk to their physicians before making decisions about work, social life or travel."

This ERACODA database was established in March 2020 and is endorsed by the European Renal Association-European Dialysis and Transplantation Association (ERA-EDTA. Participating physicians submit data voluntarily on all consecutive adult (?18 years) kidney transplant and dialysis patients treated at their centre for COVID-19, either as outpatients or in hospital. A further expansion of the database with more patient data and longer follow-up will allow additional analyses to support clinical decision-making.

With more than 7,000 active members, the ERA-EDTA is one of the biggest nephrology associations worldwide leading European nephrology and one of the most important European Medical Associations. It organizes annual congresses and other educational and scientific activities. ERA-EDTA also produces guidelines, collects data, and performs epidemiological studies through its Registry. The Society supports fellowships and educational/research projects through its committees and working groups. Its publications are NDT, CKJ (Open Access journal), and the online educational journal NDT-Educational. Website


Related Cardiovascular Disease Articles:

A talk with your GP may prevent cardiovascular disease
Having a general practitioner (GP) who is trained in motivational interviewing may reduce your risk of getting cardiovascular disease.
Dilemma of COVID-19, aging and cardiovascular disease
Whether individuals should continue to take angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in the context of coronavirus disease 2019 (COVID-19) is discussed in this article.
Air pollution linked to dementia and cardiovascular disease
People continuously exposed to air pollution are at increased risk of dementia, especially if they also suffer from cardiovascular diseases, according to a study at Karolinska Institutet in Sweden published in the journal JAMA Neurology.
New insights into the effect of aging on cardiovascular disease
Aging adults are more likely to have - and die from - cardiovascular disease than their younger counterparts.
Premature death from cardiovascular disease
National data were used to examine changes from 2000 to 2015 in premature death (ages 25 to 64) from cardiovascular disease in the United States.
Ultrasound: The potential power for cardiovascular disease therapy
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.
Despite the ACA, millions of Americans with cardiovascular disease still can't get care
Cardiovascular disease (CVD) is the leading cause of death for Americans, yet millions with CVD or cardiovascular risk factors (CVRF) still can't access the care they need, even years after the implementation of the Affordable Care Act (ACA).
Excess weight and body fat cause cardiovascular disease
In the first Mendelian randomization study to look at this, researchers have found evidence that excess weight and body fat cause a range of heart and blood vessel diseases (rather than just being associated with it).
Enzyme may indicate predisposition to cardiovascular disease
Study suggests that people with low levels of PDIA1 in blood plasma may be at high risk of thrombosis; this group also investigated PDIA1's specific interactions in cancer.
Cardiovascular disease in China
This study analyzed data from the Global Burden of Disease Study to look at the rate of cardiovascular disease (CVD) in China along with death and disability from CVD from 1990 to 2016.
More Cardiovascular Disease News and Cardiovascular Disease Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Our Relationship With Water
We need water to live. But with rising seas and so many lacking clean water – water is in crisis and so are we. This hour, TED speakers explore ideas around restoring our relationship with water. Guests on the show include legal scholar Kelsey Leonard, artist LaToya Ruby Frazier, and community organizer Colette Pichon Battle.
Now Playing: Science for the People

#568 Poker Face Psychology
Anyone who's seen pop culture depictions of poker might think statistics and math is the only way to get ahead. But no, there's psychology too. Author Maria Konnikova took her Ph.D. in psychology to the poker table, and turned out to be good. So good, she went pro in poker, and learned all about her own biases on the way. We're talking about her new book "The Biggest Bluff: How I Learned to Pay Attention, Master Myself, and Win".
Now Playing: Radiolab

First things first: our very own Latif Nasser has an exciting new show on Netflix. He talks to Jad about the hidden forces of the world that connect us all. Then, with an eye on the upcoming election, we take a look back: at two pieces from More Perfect Season 3 about Constitutional amendments that determine who gets to vote. Former Radiolab producer Julia Longoria takes us to Washington, D.C. The capital is at the heart of our democracy, but it's not a state, and it wasn't until the 23rd Amendment that its people got the right to vote for president. But that still left DC without full representation in Congress; D.C. sends a "non-voting delegate" to the House. Julia profiles that delegate, Congresswoman Eleanor Holmes Norton, and her unique approach to fighting for power in a virtually powerless role. Second, Radiolab producer Sarah Qari looks at a current fight to lower the US voting age to 16 that harkens back to the fight for the 26th Amendment in the 1960s. Eighteen-year-olds at the time argued that if they were old enough to be drafted to fight in the War, they were old enough to have a voice in our democracy. But what about today, when even younger Americans are finding themselves at the center of national political debates? Does it mean we should lower the voting age even further? This episode was reported and produced by Julia Longoria and Sarah Qari. Check out Latif Nasser's new Netflix show Connected here. Support Radiolab today at