| アブストラクト | Chronic kidney disease (CKD) is associated with increased risk of baseline mortality and severe COVID-19, but analyses across CKD stages, and comorbidities are lacking. In prevalent and incident CKD, we investigated comorbidities, baseline risk, COVID-19 incidence, and predicted versus observed one-year excess death. In a national dataset (NHS Digital Trusted Research Environment [NHSD TRE]) for England encompassing 56 million individuals), we conducted a retrospective cohort study (March 2020 to March 2021) for prevalence of comorbidities by incident and prevalent CKD, SARS-CoV-2 infection and mortality. Baseline mortality risk, incidence and outcome of infection by comorbidities, controlling for age, sex and vaccination were assessed. Observed versus predicted one-year mortality at varying population infection rates and pandemic-related relative risks using our published model in pre-pandemic CKD cohorts (NHSD TRE and Clinical Practice Research Datalink [CPRD]) were compared. Among individuals with CKD (prevalent:1,934,585, incident:144,969), comorbidities were common (73.5% and 71.2% with one or more condition[s] in respective data sets, and 13.2% and 11.2% with three or more conditions, in prevalent and incident CKD), and associated with SARS-CoV-2 infection, particularly dialysis/transplantation (odds ratio 2.08, 95% confidence interval 2.04-2.13) and heart failure (1.73, 1.71-1.76), but not cancer (1.01, 1.01-1.04). One-year all-cause mortality varied by age, sex, multi-morbidity and CKD stage. Compared with 34,265 observed excess deaths, in the NHSD-TRE and CPRD databases respectively, we predicted 28,746 and 24,546 deaths (infection rates 10% and relative risks 3.0), and 23,754 and 20,283 deaths (observed infection rates 6.7% and relative risks 3.7). Thus, in this largest, national-level study, individuals with CKD have a high burden of comorbidities and multi-morbidity, and high risk of pre-pandemic and pandemic mortality. Hence, treatment of comorbidities, non-pharmaceutical measures, and vaccination are priorities for people with CKD and management of long-term conditions is important during and beyond the pandemic. |
|---|
| ジャーナル名 | Kidney international |
|---|
| 投稿日 | 2022/6/21 |
|---|
| 投稿者 | Dashtban, Ashkan; Mizani, Mehrdad A; Denaxas, Spiros; Nitsch, Dorothea; Quint, Jennifer; Corbett, Richard; Mamza, Jil B; Morris, Tamsin; Mamas, Mamas; Lawlor, Deborah A; Khunti, Kamlesh; Sudlow, Cathie; Hemingway, Harry; Banerjee, Amitava |
|---|
| 組織名 | Institute of Health Informatics, University College London, London, UK.;Department of Non-Communicable Disease Epidemiology, London School of Hygiene and;Tropical Medicine, London, UK.;Faculty of Medicine, National Heart and Lung Institute, Imperial College London,;London, UK.;Department of Nephrology, Imperial College Healthcare NHS Trust, London, UK.;Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca,;Cambridge, UK.;Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele;University, Keele, UK.;School of Social and Community Medicine, University of Bristol, Bristol, UK.;Diabetes Research Centre, University of Leicester, Leicester, UK.;British Heart Foundation Data Science Centre, Health Data Research UK, London,;UK.;Institute of Health Informatics, University College London, London, UK; Health;Data Research UK, University College London, London, UK.;Data Research UK, University College London, London, UK; Department of;Cardiology, Barts Health NHS Trust, London, UK; Department of Cardiology,;University College London Hospitals NHS Trust, London, UK. Electronic address:;ami.banerjee@ucl.ac.uk. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35724769/ |
|---|
