- Evidence-Informed Cloth Masks: find guidance on how to make/clean/put on and take off a cloth mask.
- World Health Organization’s COVID-19 site with updates and clinical information
- Global MediXchange for Combating COVID
a compilation of Chinese experience. “This platform was established to facilitate continued communication and collaboration across borders, as well as to provide the necessary computing capabilities and data intelligence to empower pivotal research efforts. The platform can provide frontline medical teams with the necessary communication channels to share practical experience and information about fighting the pandemic.”
- Doctors of the World UK, COVID-19 advice for patients in 21 languages,
“produced in partnership with the British Red Cross, Migrant Help and Clear Voice: English, Albanian, Dari, French, Pashto, Portuguese, Bengali, Vietnamese, Kurdish Sorani is available at the moment, but more languages coming soon: Mandarin, Hindi, Urdu, Arabic, Spanish, Portuguese, Malayalam, Turkish, Farsi, Amharic, Tigrinya, Somali”
- Coronavirus tracked: the latest figures as the pandemic spreads
Open Access resource from The Financial Times
How to make a mask
- Coronavirus – guidance for anesthesia and perioperative care providers
Resources provided by The World Federation of Societies of Anaesthesiologists
- RSM COVID-19 Series: For health professionals, by health professionals
This series has been developed to support and unite all healthcare workers on the frontlines with senior decision makers leading the response in this critical fight against COVID-19, as we navigate the challenges presented by the pandemic. Chaired by leading experts, these webinars discuss different topics and challenges that healthcare workers, leaders and the public are facing, and how we are responding.
- COVID-19: Donning of Personal Protective Equipment (PPE) specific to COVID-19
Video from Public Health England: This video shows how to safely don (put on) the Personal Protective Equipment (PPE) for Aerosol Generating Procedures (AGPs) specific to COVID-19. This guidance outlines infection control for healthcare providers assessing possible cases of COVID-19.
A. Handling Dialysis during the COVID-19 pandemic
- Haemodialysis Unit Preparedness Checklist developed to deliver safe dialysis during and after COVID-19 pandemic
A checklist to help dialysis units prepare for possible arrival of patients with COVID-19 by The George Institute for Global Health
- Frontline health workers in COVID-19 prevention and control: rapid evidence synthesis
A rapid review of global evidence in a systematic manner to inform decision making contextualised to context by The George Institute for Global Health
For additional information, visit The George Institute for Global Health
- US Centers for Disease Control and Prevention (CDC) guidance for patients on outpatient dialysis
- Staying Safe During Dialysis and the COVID-19 Outbreak – National Kidney Foundation
- Preventive measures in haemodialysis centre of Policlinico Milan during COVID-19 Epidemic
Description of the preventive measures put in action in the dialysis centre at the Policlinico of Milan since the very beginning of the start of the COVID19 epidemic.
- Recomendações de Boas Práticas da Sociedade Brasileira de Nefrologia
In Portuguese. Recommendations from the Brazilian Society of Nephrology
- COVID-19 Flowchart
Used by the Nephrology & Renal Transplantation Unit in Leuven, Belgium; and by the International Renal Research Institute, San Bortolo Hospital, Vicenza, Italy. Provided by Dr. Björn Meijers
- Recomendações para pacientes pediátricos em hemodálise
Guidelines for pediatric patients in dialysis, peritoneal dialysis and transplanted patients by the Brazilian Society of Nephrol
- Strategies regarding COVID-19 in PD patients.From the ISPD Standards and Guidelines Committee
The ISPD Standards and Guidelines Committee has been working to adapt the recommendation of the Peking University First Hospital for PD patients during the COVID-19 crisis. Also available in many other languages
- Management Of Patients On Dialysis And With Kidney Transplant During SARS-COV-2 (COVID-19) Pandemic In Brescia, Italy
- Organization of Preventive Measures against COVID-19 Infection Dissemination in the Nephrology HD Centers
- Coronavirus destroys lungs. But doctors are finding its damage in kidneys, hearts and elsewhere
- Protocol for haemodialysis unit in covid 19 pandemic
safety of health care workers and patients during haemodialysis incovid 19 pandemic in dialysis unit from pgimer, chandigargh
B. Guidance for other kidney diseases (including transplant)
- Conceptos actuales sobre el compromiso del riñón en la pandemia coronavirus 19 (Sars CoV-2)
- The Chilean Kidney Education Foundation, a non-profit organization linked to the Chilean Society of Nephrology, has created a digital platform open to the community to support, guide, and educate patients with CKD
- Colombian consensus SARS-CoV-2 / COVID-19 infection in people with Chronic Kidney Disease; C10 resources
- COVID-19 Guidance from the Transplant Infectious Disease Section of The Transplantation Society
- EL RIÑÓN EN LA PANDEMIA DEL CORONAVIRUS-19
In Spanish: Summary description of The Novel Coronavirus 2019 epidemic and kidneys
- Protocolo de orientação para colegas que cuidem de pacientes portadores de doenças renais raras em virtude da epidemia da sars cov2 . In Portuguese.
Guidelines for rare renal diseases by the Brazilian Society of Nephrology
- Please visit the SLANH website for materials on COVID-19.
SLANH has shared the two resources below on caring for renal patients during COVID-19:
- Guidance for clinicians with patients receiving immunosuppression treatment for autoimmune conditions of their native kidneys during COVID-19– from The Renal Association
A printable PDF version of this page is available here
To provide therapeutic guidance on the management of patients receiving immunosuppression for autoimmune conditions.
- Stratified risk for prolonged self isolation for adults and children who are receiving immunosuppression for disease of their native kidneys
The RA renal risk stratification for which renal patients in this group should be in prolonged self isolation (also called shielding) can be found at: https://renal.org/stratified-risk-prolonged-self-isolation-adults-children-receiving-immunosuppression-disease-native-kidneys/
- Coronavirus guidance for patients with kidney disease. From Kidney Care-UK
The latest news and information on COVID-18 for kidney patients
- Resources from ERA-EDTA
COVID-19, the Novel Corona Virus – New and information for the ERA-EDTA community and kidney patients
- The ASN resource page
Resources provided by the ASN
- COVID-19 dashboard from TTS
Addresses the important information needs of the international professional transplant community during this pandemic.
- Russian Dyalisis Society
- COVID-19 pandemic waves and mortality among patients on kidney replacement therapy
Using data from the largest European database of KRT patients with COVID-19, that was collected at multiple centers across Europe and has detailed information on key covariates, we compared mortality between the first and second pandemic waves among dialysis patients and kidney transplant recipients with COVID-19.
- A retrospective cohort study measured predicting and validating the impact of the COVID-19 pandemic in individuals with chronic kidney disease.
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.
- Immunologic Responses Following COVID-19 Vaccination in Patients with Membranous Nephropathy Receiving Anti-CD38 Felzartamab Therapy: Results from the Phase 1b/2a M-PLACE Study
Mass vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been one of the pivotal public health strategies to curb the coronavirus disease 2019 (COVID-19) outbreak. Currently, there are insufficient data on the immune response to COVID-19 vaccines in patients with autoimmune kidney diseases, especially those receiving immunosuppressive drugs.
- COVID-19 vaccination in patients with membranous nephropathy
While the benefit of COVID-19 vaccination is evident, many patients and caregivers might question the safety of COVID-19 vaccines in view of case reports that reported relapsing disease after vaccination (1-4). A balanced discussion is difficult, in view of lacking data.
- Efficacy of anti SARS-CoV-2 monoclonal antibodies prophylaxis and vaccination on Omicron COVID-19 in kidney transplant recipients
Solid organ transplantation (SOT) recipients are at very high risk of developing severe COVID-19. Despite the implementation of a third dose of mRNA vaccine, the efficacy of SARS-CoV-2 vaccination on humoral and cellular immunities is reduced in this population, resulting in increased severe infections and mortality, including in fully vaccinated patients.
- Inferior cellular and humoral immunity against Omicron and Delta VOC compared to SARS-CoV-2 wild-type in hemodialysis patients immunized with four SARS-CoV-2 vaccine doses
With the dominance of the most recent SARS-CoV-2 variant of concern (VOC) Omicron (B.1.1.529), the question arises, what is the reason for its high contagiousness in COVID-19 vaccinated dialysis patients as compared to the previous SARS-CoV-2 variants Delta and wild-type.
- Humoral response to heterologous SARS-CoV-2 vaccination in kidney transplant patients is heterogeneous and dose-dependent
Vaccination is the cornerstone in the fight against the ongoing COVID-19 pandemic. Kidney transplant recipients (KTR) had a weak immunological response after 2 doses of either vaccine scheme.
- SARS-CoV-2 infection evolution among nephrologists during the pandemic: clinical features and impact of vaccination
Exposure of healthcare workers (HCW) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in high rates of coronavirus-19 disease (COVID-19). Nephrologists have been at the front line as patients on kidney replacement therapy present more severe COVID-19 and need continuous medical assistance
- Early treatment with sotrovimab monoclonal antibody in kidney transplant recipients with Omicron infection
Since its first detection in November 2021, the SARS-CoV-2 B.1.1.529 (Omicron) variant has rapidly become the dominant variant worldwide. Increased transmissibility and its ability to evade both vaccine and infection induced neutralising antibodies was of significant global concern, and was the impetus for the UK to expedite it’s booster vaccination programme.
- Suboptimal antibody response against SARS-CoV-2 Omicron variant after third dose of mRNA vaccine in kidney transplant recipients
Coronavirus disease (COVID-19) caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) has resulted in over five million deaths worldwide with the Delta (B.1.617.2) and more recently the Omicron (B.1.1.529) variants accounting for the majority of cases.
- Early treatment with sotrovimab monoclonal antibody in kidney transplant recipients with Omicron infection
Early data about COVID-19 related to SARS-CoV-2 Omicron variant (B.1.1.529) suggest that it may be less severe than prior variants of concern in the general population.
- Humoral response after a fourth “booster” dose of a Covid-19 vaccine following a 3-dose regimen of mRNA-based vaccination in dialysis patients
Despite an initial satisfactory increase in SARS-CoV-2 anti-spike antibody (Ab) titer after completing a 3-dose regimen in the first set of vaccination in dialysis patients,1 Ab titer substantially decreases at 6 months in this population
- COVID-19 vaccination response in kidney transplant recipients with and without mycophenolate mofetil: follow-up of a randomized controlled trial
Antimetabolite therapy is considered a risk factor for poor vaccination response to COVID-19 vaccination.
- Early administration of Anti-SARS-CoV-2 Monoclonal Antibodies prevents severe Covid-19 in Kidney Transplant Patients
Kidney transplant recipients (KTRs) are prone to develop severe coronavirus disease 2019 (Covid-19) and are less well protected by vaccine than immunocompetent subjects.
- The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis Patients in Turkey
Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.
- Concurrent vaccination of kidney transplant recipients and close household cohabitants against COVID-19
Kidney transplant recipients (KTRs) are highly vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe coronavirus disease 2019 (COVID-19). The 28-day case mortality in KTRs is 24%, and mounting evidence suggests poor immunogenicity and clinical effectiveness of vaccines in this group.
- Inferior humoral and sustained cellular immunity against wild type and omicron VOC in hemodialysis patients immunized with three SARS-CoV-2 vaccine doses compared to four doses
Studies analyzing humoral immunity against the most recent SARS-CoV-2 variant of concern (VOC) omicron (B.1.1.529) in general population demonstrate a clear benefit of an additional boost with respect to neutralization capacity, and several national health authorities recommend the fourth vaccination dose.
- Understanding the Risks of Immunosuppression Reduction For Active COVID-19 Infection
Kidney transplant recipients (KTRs) are at higher risk of mortality and morbidity of COVID-19 infection compared to the general population. Some of this elevated risk comes from non-modifiable factors common to KTRs, such as diabetes, hypertension, and chronic kidney disease.
- Antibody responses to 2 doses of mRNA Covid vaccine in pediatric renal patients
Studies in adult patients with kidney diseases have shown an attenuated immune response to natural Covid and Covid vaccination. In adolescents, the pivotal trial of BNT162b2 demonstrated a far higher neutralizing antibody titer in adolescents compared with adults
- A fourth dose of the mRNA-1273 SARS-CoV-2 vaccine improves serum neutralization against the delta variant in kidney transplant recipients
Research has suggested that even three doses of SARS-CoV-2 mRNA-based vaccines might be unable to elicit a sufficient immune response in immunocompromised kidney transplant recipients.
- COVID-19 in dialysis: clinical impact, immune response, prevention and treatment
The SARS-CoV-2 pandemic has profound adverse effects on the dialysis population. Patients requiring dialysis are at increased risk of SARS-CoV-2 infection and mortality, and many have experienced psychological distress, as well as delayed or suboptimal care.
- Breakthrough Omicron COVID-19 infections in patients receiving REGEN-Cov antibody combination
COVID-19 vaccines are efficient to prevent severe COVID-19 infections. Immunocompromised patients are at increased risk of both severe COVID-19 and poor immunologic response to anti-SARS-CoV-2 vaccines.
- A fourth SARS-Cov-2 mRNA vaccine in strictly seronegative kidney transplant recipients
Solid organ transplant recipients have demonstrated a lower humoral immune response to SARS-Cov-2 mRNA vaccination, leading transplant physicians to perform a third vaccine injection.
- A comprehensive assessment of long-term SARS-CoV-2-specific adaptive immune memory in convalescent COVID-19 Solid Organ Transplant recipients
Long-term adaptive immune memory has been reported among immunocompetent individuals up to eight months following SARS-CoV-2 infection. However, limited data is available in convalescent patients with a solid organ transplant.
- A vector-based vaccine dose after three doses of mRNA-based COVID-19 vaccination does not substantially improve humoral SARS-CoV-2 immunity in renal transplant recipient
The Coronavirus disease 2019 (COVID-19) related mortality in kidney transplant recipients (KTX) is significantly higher when compared to non-transplant patients. Vaccination against the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is the most efficient measure to protect this vulnerable population.
- Dialysis staff-reported impact of COVID-19 on early kidney transplant steps
COVID-19 has influenced multiple aspects of kidney transplantation, the preferred treatment for the majority of patients with end-stage kidney disease (ESKD). Patients with ESKD and transplant recipients are vulnerable to severe COVID-19 illness given the high prevalence of comorbidities and immunosuppression in these populations.
- SARS-CoV-2 vaccination-associated collapsing glomerulopathy in a kidney transplant recipient.
A stable kidney transplant recipient (KTR) of 14 years received the SARS-CoV-2 ChAdOx1 (AZD1222) vaccine and, within a fortnight, presented with severe acute kidney injury (AKI) -creatinine 533μmol/L (baseline 125-187μmol/L) and nephrotic range proteinuria (urine PCR=2000g/mol, no hematuria).
- REGEN-Cov antibody combination to prevent COVID-19 infection in kidney transplant recipient without detectable antibody response to optimal vaccine scheme
A large part of kidney transplant recipient (KTR) do not respond to anti-SARS-Cov-2 vaccine. Indeed, concordant data indicate that about thirty percent of KTR do not develop antibodies after three doses of mRNA vaccines.
- Collapsing Glomerulopathy following SARS-CoV-2 adenovirus-vector based vaccine: report of two cases
In the setting of the rapid spread of the pandemic by the new coronavirus (COVID-19) and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the kidney was recognized as a frequent target. With the beginning of vaccination for COVID-19, several cases of post-vaccination immunological manifestations have been described.
- Natural SARS-CoV-2 infection results in higher neutralization response against variants of concern compared to two-dose BNT162b2 vaccination in kidney transplant recipients
Seroconversion rates in kidney transplant recipients (KTR) after two-dose BNT162b2 mRNA vaccination are in the range of 3-59% and thus significantly lower compared to the greater than 90% achieved in healthy controls. In convalescent COVID-19 patients, antibody levels decline only slightly after 6-8 months, whereas vaccine-induced immunity appears to decrease more rapidly.
- The global impact of the Coronavirus 2019 pandemic on in-centre haemodialysis services: an International Society of Nephrology -Dialysis Outcomes Practice Patterns Study survey.
To assess the impact of the COVID-19 pandemic impact on haemodialysis centres, The Dialysis Outcomes and Practice Patterns Study and International Society of Nephrology (ISN) collaborated on a web-survey of centres.
- Humoral response to SARS-CoV-2 in hemodialysis patients
Patients with end stage renal disease (ESRD) require maintenance dialysis while waiting for a kidney transplant or if not eligible for a transplant. Even with significant improvements in hemodialysis and peritoneal dialysis there is still a high mortality rate. Infections are one of the major causes of death in renal patients requiring dialysis due to an impaired innate and adaptive immune system induced by uremia.
- Immune response to SARS-CoV2 infection and vaccination in patients receiving kidney replacement therapy
In this issue of the Journal, the initial experience regarding the immunogenicity of prior COVID-19 infection and the response to the COVID-19 vaccines among patients on maintenance dialysis and kidney transplant recipients is summarized.
- Longevity of SARS-CoV-2 immune responses in hemodialysis patients and protection against reinfection
Patients with end stage kidney disease receiving in-center hemodialysis (ICHD) have had high rates of SARS-CoV-2 infection. Following infection, patients receiving ICHD frequently develop circulating antibodies to SARS-CoV-2, even with asymptomatic infection. Here, we investigated the durability and functionality of the immune responses to SARS-CoV-2 infection in patients receiving ICHD
- Gross hematuria following vaccination for severe acute respiratory syndrome coronavirus 2 in 2 patients with IgA nephropathy
Several of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines use a nucleoside-modified, purified mRNA lipid nanoparticle-encapsulated platform. Compared with traditional inactivated viral and adjuvanted protein vaccines, this RNA platform elicits far higher neutralizing antibody titers, stronger antigen-specific cluster of differentiation (CD) 4+ and CD8+ T-cell responses, and stronger germinal center B and TFH cell activation in experimental animals.
- Weak anti–SARS-CoV-2 antibody response after the first injection of an mRNA COVID-19 vaccine in kidney transplant recipients
International recommendations on coronavirus disease 2019 (COVID-19) vaccine distribution have given priority to immunocompromised patients, including kidney transplant recipients (KTRs). Unfortunately, this guidance has been released without inclusion of this clinical population in vaccine clinical trials.
- SARS-CoV-2-reactive cellular and humoral immunity in hemodialysis population
The outcome of SARS-CoV-2 infection in hemodialysis (HD) patients is significantly worse compared to the general population. Whether the SARS-CoV-2-specific immunity in dialysis patients with COVID-19 is impaired as a possible cause for the inferior outcome is not known so far.
- Low immunization rates among kidney transplant recipients who received two doses of the mRNA-1273 SARS-CoV-2 vaccine
The efficacy rates of vaccines to prevent infection with SARS-CoV-2 have not been specifically investigated in kidney transplant recipient (KTRs). Preliminary results suggest that among KTRs who received the first injection of an mRNA-based vaccine the antibody response is weak.
- Experience with SARS-COV-2 BNT162b2 mRNA vaccine in dialysis patients
The immune system is profoundly affected by uremia. End stage kidney disease (ESKD) patients may be more vulnerable to infections and may have suboptimal response to vaccination1. For the SARS-COV-2 (COVID-19), patients with ESKD are at increased risk of infection and mortality.
- Seroprevalence of antibody to S1 spike protein following vaccination against COVID-19 in patients on haemodialysis. A call to arms
Adult patients with end-stage kidney disease (ESKD) on haemodialysis are at increased risk of coronavirus disease 2019 (COVID-19) infection and death. This group is often multi-racial, suffer from many comorbidities and can be socio-economically deprived; all factors strongly associated with COVID-19 mortality.
- Antibody response to BNT162b2 vaccine in maintenance hemodialysis patients
Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France.
- Neutralizing SARS-CoV-2 antibody response in dialysis patients after the first dose of the BNT162b2 mRNA Covid-19 vaccine. The war is far from being won.
On December 21, 2020, the European Commission granted conditional marketing approval to the BNT162b2 Covid-19 mRNA vaccine developed by BioNTech. In the general population, the first dose of BNT162b2 was reported to produce a rapid antibody response with 52% efficacy in preventing severe infection, similar to the protection induced by the natural disease.
- Bamlanivimab decreases severe outcomes of SARS-CoV-2 infection in ANCA vasculitis patients
Patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are more likely to have poor outcomes if infected with SARS-CoV-2.
- A Mobile Health-based Survey to Assess COVID-19 Vaccine Intent and Uptake Among Patients on Dialysis
Patients with kidney failure on dialysis suffer high rates of COVID-19-associated hospitalizations and mortality. Vaccination is crucial to mitigate the risks of COVID-19, but concerningly, one in five patients receiving in-center hemodialysis are vaccine hesitant.
- Association of ethnicity and socioeconomic status with COVID-19 hospitalisation and mortality in those with and without chronic kidney disease
In the UK, as of July 2021, there have been over 4.5 million confirmed cases of coronavirus disease‐2019 (COVID‐19) and over 150,000 deaths caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) [S1]. Data are being reported on subpopulations most at risk of COVID-19 and its severest forms.
- SARS-CoV-2 vaccine response in ANCA associated vasculitis patients
The development of COVID-19 vaccines and mass vaccination is a landmark achievement of modern medicine. Management of patients with anti-neutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis (AAV) during the pandemic has been challenging.
- Observations on improving Covid-19 vaccination responses in Kidney Transplant Recipients: heterologous vaccination and immunosuppression modulation
Solid organ transplant recipients have a weaker humoral response to Covid-19 vaccination due to several factors, including lymphopenia associated with immunosuppressive therapies (particularly Belatacept, antiproliferative drugs and steroids).
- A prospective observational study for justification, safety, and efficacy of a third dose of mRNA vaccine in patients receiving maintenance hemodialysis.
The level of protection achieved by the standard two doses of COVID-19 mRNA vaccines in patients receiving maintenance hemodialysis (MHD) remains unclear. To study this we used the French Renal Epidemiology and Information Network (REIN) Registry to compare the incidence and severity of 1474 cases of COVID-19 diagnosed in patients receiving MHD after none, one or two doses of vaccine.
- Antibody response to COVID-19 booster vaccine in rituximab treated patients with ANCA associated vasculitis
The success of the coronavirus infectious disease 2019 (COVID-19) vaccine has been accompanied by challenges, which include suboptimal response in patients on immunosuppression.
- Waning humoral response six months after SARS-CoV-2 vaccination with the mRNA-BNT162b2 vaccine in hemodialysis patients – time for a boost
We and others have found a high short-term seroconversion rate between 71% and 98% in hemodialysis patients following a complete two-dose vaccination course with the mRNA-BNT162b2 vaccine.
- The Evolving Practice of Nephrology During the COVID-19 Pandemic in Brunei Darussalam
Brunei has the fifth highest incidence of kidney failure globally. There have been significant changes to the nephrology practice locally since the second wave of the pandemic in August 2021.
- Elevated NGAL is Associated with the Severity of Kidney Injury and Poor Prognosis of Patients with COVID-19
Loss of kidney function is a common feature of COVID-19 infection, but serum creatinine (SCr) is not a sensitive or specific marker of kidney injury. We tested whether molecular biomarkers of tubular injury measured at hospital admission were associated with AKI in those with COVID-19 infection.
- A Pilot Study of Urine Proteomics in Covid-19-associated Acute Kidney Injury
Acute kidney injury (AKI) is a major complication associated with COVID-19 and occurs in up to 76% of intensive care unit patients. The mortality rate of COVID-19 patients who developed AKI (COVID-AKI) is more than 10 times higher than those who did not
- Improved cellular and humoral immunity upon a second BNT162b2 and mRNA-1273 boost in prime-boost vaccination no/low responders with end-stage renal disease
Patients with end-stage renal disease (ESRD) develop inefficient immune responses upon vaccination and have a high-risk of developing severe COVID-19. The globally expanding SARS-CoV-2 variant of concern (VOC), B.184.108.40.206/Delta, evades immune responses and might constitute a particular threat to these patients.
- Antibody and T cell response to a third dose of SARS-CoV-2 messenger RNA BNT162b2 vaccine in kidney transplant recipients
SARS-CoV-2 vaccination has become the standard of care for the prevention of severe COVID-19, with a strongly positive impact in countries in which vaccination has been effectively promoted S1. In KTR, SARS-CoV-2 vaccination has been recommended through international guidelines.
- The SARS-CoV-2 neutralizing capacity of kidney transplant recipients four weeks after receiving a second dose of the BNT162b2 vaccine
COVID-19 vaccinated kidney transplant recipients (KTRs) display a lower-than-normal antibody (Ab) response towards SARS-CoV-2, indicating a reduced humoral immune response against the virus.
- COVID-19 Vaccination Followed by Activation of Glomerular Diseases Does Association Equal Causation?
To date over 4 billion doses of the various Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been administered worldwide in response to the Coronavirus Disease 2019 (COVID-19) pandemic.
- NAD+ biosynthetic impairment and urinary metabolomic alterations observed in hospitalized adults with COVID-19-related acute kidney injury
Acute kidney injury (AKI) is common in COVID-19 and associated with increased morbidity and mortality. We investigated alterations in the urine metabolome to test the hypothesis that impaired nicotinamide adenine dinucleotide (NAD+) biosynthesis and other deficiencies in energy metabolism in the kidney, previously characterized in ischemic, toxic, and inflammatory etiologies of AKI, will be present in COVID-19-associated AKI.
- A third vaccine dose substantially improves humoral and cellular SARS-CoV-2 immunity in renal transplant recipients with primary humoral non-response
Renal transplant recipients (RTR) are at high risk for fatal Coronavirus disease 2019 (COVID-19). Vaccinations are indispensable to protect this vulnerable population. Unfortunately, >50% of solid organ recipients do not mount antibody responses after two doses of SARS-CoV-2-mRNA vaccines.
- COVID-19 vaccine hesitancy in patients on dialysis in Italy and France
Patients on dialysis (HDP) are a category at high risk from COVID-19 and thus a high-priority group for vaccination. COVID-19 vaccine hesitancy has been a concern since the availability of the first vaccine. The objective of this study was to determine hesitancy rates and factors associated with hesitancy towards COVID-19 vaccination in HDP.
- Impact of rituximab on humoral response to COVID-19 booster vaccine and antibody kinetics in patients with ANCA vasculitis
The advent of vaccines has resulted in mitigation of severe disease as a consequence of SARS-CoV-2. There is notable absence of humoral absence after two doses of mRNA vaccines in rheumatic and musculoskeletal diseases.
- Casirivimab-Imdevimab (REGN-COV2) for Mild-to-Moderate SARS-CoV2 Infection in Kidney Transplant Recipients.
Kidney transplant recipients are an immunocompromised population, many with comorbid diseases such as obesity, diabetes, and coronary artery disease, that may increase their risk for developing severe coronavirus disease 2019 (COVID-19).
- Risks factors associated with poor response to COVID-19 vaccination in kidney transplant recipients
The case fatality ratio of COVID-19 in kidney transplant recipients (KTR) is between 10-30%, underscoring the importance of vaccination to prevent COVID-19. However, KTR have a reduced response to COVID-19 vaccines.
- A third injection of BNT162b2 mRNA Covid-19 vaccine in kidney transplant recipients improves the humoral immune response
A letter to the editor from Masset et al.
- ACE2 Decreased Expression During Kidney Inflammatory Diseases: Implications to Predisposing to COVID 19 Kidney Complications
Kidneys are a common target of SARS-CoV-2 infection. Both roles for direct viral infection and downstream effects of cytokine storm syndrome have been suggested as mechanisms driving kidney injury in patients with COVID-19.
- SARS-CoV-2 Shedding in Dialysis Patients With COVID-19
We performed a quality assurance/quality improvement project using COVID-19 PCR Ct values as a surrogate to assess the risk of infectious virus shedding in COVID-19−positive ESKD patients, with the objective of informing a discontinuation of isolation protocol for patients in our dialysis units.
- Membranous nephropathy following anti-Covid-19 mRNA vaccination.
A 76-year-old man with a past history of hypertension and UV-treated cutaneous mycosis fungoid, was vaccinated in January 2021 for SARS-CoV2 with Bnt162b2 and developed an antibody response.
- Anti-SARS-CoV-2 Spike Protein S1 Receptor-Binding Domain Antibody to An Inactivated Whole-virus SARS-CoV-2 Vaccination in End-stage Kidney Disease Patients: An Initial Report
Patients with end-stage kidney disease (ESKD) are at greater risk for morbidity and mortality following coronavirus disease 2019 (COVID-19) than the general population.
- ANCA vasculitis induction management during the COVID-19 pandemic
As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic evolved and became a global health threat, the safety of immunosuppression in anti-neutrophil cytoplasmic antibody associated vasculitis (AAV) became utmost important for clinicians and patients.
- “A case of ANCA-associated vasculitis after AZD1222 (Oxford-AstraZeneca) SARS-CoV-2 vaccination: Casuality or causality?”
Two cases of anti–neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis after SARS-CoV-2 vaccination have been reported to date, and both appeared after Moderna (mRNA) vaccination.
- ANCA-associated Glomerulonephritis Following the Pfizer-BioNTech COVID-19 Vaccine
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused significant global morbidity and mortality since first emerging as a pathogen at the end of 2019. Acute kidney injury, most commonly due to acute tubular injury, is a frequent finding in COVID-19, occurring in 17-37% of patients.
- The high mortality and impact of vaccination on COVID-19 in hemodialysis population in India during the second wave
Patients getting in-centre hemodialysis (HD) have been disproportionately affected by Covid-19 infection. India has seen two waves of SARS-Cov2 infection in 2020 and 2021, with the second wave being more intense.
- Relapse of Class V Lupus Nephritis after Vaccination with COVID-19 mRNA Vaccine
We present the case of a 42-year-old female patient who was diagnosed with Lupus nephritis class V in 2016 on renal biopsy after she developed typical butterfly rash and nephrotic syndrome with proteinuria of 6g/day.
- Scleroderma renal crisis following mRNA vaccination against SARS-CoV-2
Here we describe an original case of scleroderma renal crisis (SRC) following mRNA vaccination against SARS-CoV-2.
- Should vaccination against COVID 19 be mandated in patients on the transplant waiting list?
Concordant studies report a very high mortality rate during COVID-19 infection in kidney transplant recipients (KTR).
- A multi-center retrospective cohort study defines the spectrum of kidney pathology in Coronavirus 2019 Disease (COVID-19)
Kidney failure is common in patients with Coronavirus Disease-19 (COVID-19) resulting in increased morbidity and mortality. In an international collaboration, 284 kidney biopsies were evaluated to improve understanding of kidney disease in COVID-19.
- Perpetual Lockdown: The state of COVID-19 and kidney disease in the Philippines
This article highlights the current state of the COVID-19 pandemic in the country and its consequences on Filipinos with chronic kidney disease.
- COVID-19-Associated Decline in the Size of the End Stage Kidney Disease Population in the United States
Recent forecasting of the size of the ESKD population had suggested continued growth during the 2020’s.3 However, no forecast could have anticipated the novel coronavirus disease 2019 (COVID-19) pandemic.
- Neutralizing SARS-CoV-2 antibody response and protective effect of two doses of ChAdOx1 nCoV-19 and BBV152 vaccines in hemodialysis patients – preliminary report
Two vaccines, ChAdOx1 nCoV-19 (Astra Zeneca) and BBV152 (COVAXIN®, Bharat Biotech) are currently approved in India.
- The “New Caledonia COVID-19 Paradox”: Dramatic Indirect Impact of the Pandemic on Organ Donation and Transplantation in a Non-prevalence Country
With 270,000 inhabitants, New Caledonia has a very high prevalence of End-stage Kidney Disease (ESKD), with the fourth-highest globally.
- The ROMANOV study found impaired humoral and cellular immune responses to SARSCov-2 mRNA vaccine in virus unexposed patients receiving maintenance hemodialysis
Excluded from pivotal studies, it is not known whether patients on maintenance hemodialysis are protected after the “standard” two doses of mRNA vaccines. To answer this, anti-spike receptor binding domain (RBD) IgG and interferon gamma-producing CD4+ and CD8+ specific-T cells were measured in the circulation 10-14 days after the second injection of BNT162b2 vaccine in 106 patients receiving MHD and compared to 30 healthy volunteers.
- Superior cellular and humoral immunity towards SARS-CoV-2 reference and alpha and beta VOC strains in COVID-19 convalescent as compared to the prime boost BNT162b2 vaccinated dialysis patients
A letter to the editor by Blazquez-Navarro et al.
- Comparison of BNT162b2 (BioNTech/Pfizer) and mRNA-1273 (Moderna) SARS-CoV-2 mRNA vaccine immunogenicity in dialysis patients
A letter to the editor by Kaiser et al.
- Neutralizing antibody response against variants of concern after vaccination of dialysis patients with BNT162b2
A letter to the editor by Speer et al.
- Reasons for COVID-19 vaccination hesitancy in hemodialysis patients
A letter to the editor by Sunil Bhandari.
- Clinical utility of biochemical markers for the prediction of COVID-19-related mortality in kidney transplant recipients
Coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a significant threat for patients with pre-existing renal disease – including kidney transplant recipients (KTRs). S1, S2 While there is ample literature to suggest a role for kidney impairment in the severity of COVID-19, its clinical course in KTRs can vary widely from minimal symptoms to life-threatening illness.
- Survey of Telemedicine by Pediatric Nephrologists During the COVID-19 Pandemic
The effects of the coThe slow increase in telemedicine utilization expanded rapidly, along with reimbursement changes, during the COVID-19 pandemic. Standardized protocols for these services are lacking but are needed for effective and equitable healthcare.
- Systematic Review of Early Immune Response to SARS-CoV-2 Vaccination Among Patients with Chronic Kidney Disease
The effects of the coronavirus disease 19 (COVID-19) pandemic in particular affect those with chronic kidney disease (CKD), who commonly have defects in humoral and cellular immunity, and the efficacy of vaccinations against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is uncertain.
- Nephrotic syndrome following ChAdOx1 nCoV-19 vaccine against SARScoV-2
There have been multiple reports of nephrotic syndrome following the Pfize-BioNTech COVID-19 vaccine.1-3 We report a similar case of nephrotic syndrome which developed shortly after receiving ChAdOx1 nCoV-19 vaccine against SARS CoV -2 developed by Oxford University and AstraZeneca (Covishield , Serum Institute of India, Pune, India).
- Use and safety of remdesivir in kidney transplant recipients with COVID-19
Remdesivir has demonstrated antiviral activity against coronavirus, shortening the time to recovery in adults hospitalized with moderate/severe COVID-19. Severe adverse events such as acute kidney injury (AKI) have been reported. There is little available data on the use and safety of remdesivir in kidney transplant (KT) recipients.
- Brazil and the COVID-19 pandemic
When the World Health Organization (WHO) announced the emergence of several cases of pneumonia in Wuhan City, Hubei Province, China, healthcare systems across the globe turned their attention to the new strain of coronavirus, SARS-CoV-2, responsible for causing the highly infectious respiratory illness, COVID-19.
- Granulomatous vasculitis after the Astra-Zeneca anti-SARS-CoV-2 vaccine.
Several reports of newly diagnosed or relapses of immune-mediated renal diseases following vaccination with anti-SARS-CoV-2 mRNA and Astra-Zeneca vaccines recently emerged in the litterature.
- IgA Nephropathy presenting as macroscopic hematuria in 2 pediatric patients after receiving the Pfizer COVID-19 vaccine
With great interest, we read the recent reports of IgA nephropathy (IgAN) flare-up presenting as macroscopic hematuria, following the second dose of coronavirus disease 2019 (COVID-19) vaccination in adult patients.
- Bamlanivimab For Mild to Moderate COVID-19 in Kidney Transplant Recipients
Kidney Transplant Recipients (KTR) are at an increased risk of hospitalization, complications, and mortality from COVID-19 compared to the general population. Among KTRs with COVID-19 in the United States, studies have shown hospitalization rates ranging from 32% -100%, Intensive Care Unit (ICU) admission rates from 20-61% and overall mortality of 13% to 39%.
- Riding the COVID-19 Tsunami in India – A nephrologist’s perspective
The Coronavirus Disease 2019 (COVID-19) pandemic has brought about the realization that the true progress of a nation can be determined from the strength of its healthcare system. The country of India, and the battle it is waging with the Severe Acute Respiratory Syndrome – Coronavirus 2(SARS-CoV2), has become a striking example of how lack of pandemic preparedness can bring a nation to dire circumstances.
- Challenges in kidney care in a lower middle income country during the COVID-19 pandemic – the Ghanaian perspective
Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, is a highly infectious respiratory disease associated with high mortality rates globally. The recorded cases and mortalities in Sub-Saharan Africa (SSA) have been less devastating compared to other continents. Low testing capacity, genetics and environmental factors have been hypothesized as reasons why SSA, including Ghana, has had lower incidence and mortality rates.
- Deceased Donor Kidneys Utilization and Discard Rates During COVID-19 Pandemic in the United States
The COVID-19 pandemic created significant disruptions to kidney transplantation in the United States. Particularly in the initial surge, there was a dramatic decrease in deceased donor transplants, a near complete cessation in living donor kidney transplants, and considerable mortality among kidney transplant candidates.
- Histologic correlates of gross hematuria following Moderna COVID-19 vaccine in patients with IgA nephropathy
We read with interest the recent reports of gross hematuria occurring in 4 patients with IgA nephropathy shortly following the second dose of mRNA vaccine for coronavirus disease 2019 (COVID-19). These include 2 cases following the Moderna vaccine and 2 following the Pfizer BioNTech vaccine.
- Adaptive lymphocyte profile analysis discriminates mild and severe forms of COVID-19 after solid organ transplantation
Solid organ transplant recipients are at high risk for the development of severe forms of COVID-19. However, the role of immunosuppression in the morbidity and mortality of the immune phenotype during COVID-19 in transplant recipients remains unknown.
- Emergency Production and Collection of Dialysate for CVVHD during the COVID-19 pandemic
The COVID-19 pandemic has resulted in a significant increase in the need for kidney replacement therapy (KRT) due to the high incidence of acute kidney injury (AKI) associated with COVID-19, with early reports claiming an incidence rate of 40-50% in critical care patients.
- Relapse of IgG4 related nephritis following mRNA Covid vaccine
SARS-Cov-2 vaccination is currently recommended for patients with chronic kidney disease and immunocompromised patients because their risk of developing severe forms of Covid-19 is higher than other patients. Several reports have highlighted the increased risk of immune disease recurrence following mRNA vaccination, including Minimal Change Disease, Membranous Nephropathy or even acute allograft rejection.
- Comparison of COVID-19 versus influenza on the incidence, features, and recovery from acute kidney injury in hospitalized United States Veterans
Acute kidney injury is a common complication in patients hospitalized with SARSCoV-2 (COVID-19), with prior studies implicating multiple potential mechanisms of injury. Although COVID-19 is often compared to other respiratory viral illnesses, few formal comparisons of these viruses on kidney health exist.
- De novo vasculitis after mRNA-1273 (Moderna) vaccination
The mRNA-1273 (Moderna) vaccine is a lipid nanoparticle–encapsulated mRNA-based vaccine that encodes the prefusion stabilized full-length spike protein of SARS-Cov-2, the cause of the current Covid-19 pandemic. In a randomized, placebo-controlled phase 3 trial, the mRNA-1273 (Moderna) vaccine showed high efficacy at preventing Covid-19 illness. Aside from transient local and systemic reactions, no safety concerns were identified.
- ANCA GLOMERULONEPHRITIS POST MODERNA COVID-19 VACCINATION
As covid-19 vaccinations are administered globally on a massive scale, rare adverse events are being reported. We report a case of ANCA glomerulonephritis 2 weeks post covid-19(Moderna) vaccine.
- Humoral response of mRNA-1273 SARS-CoV-2 vaccine in peritoneal dialysis patients
End-stage kidney disease patients on peritoneal dialysis are known to have an altered cellular and humoral immunity evidenced by the reduced response they have to several vaccines, such as the hepatitis B or influenza vaccine, albeit their response rate is slightly higher than patients on hemodialysis.
- Gross hematuria following SARS-CoV-2 vaccination in patients with IgA nephropathy
Following the publication of the two letters by Negrea et al1 and Rahim et al2, we herein describe three additional patients with IgA nephropathy (IgAN) who developed gross hematuria after receiving SARS-CoV-2 mRNA-based vaccines. The clinical data of our cases are summarized in Table 1. In line with the three previously reported cases, patient #1 had normal kidney function. However, patients #2 and #3 were treated with kidney transplantation (KT) and hemodialysis, respectively.
- Is COVID-19 Vaccination unmasking Glomerulonephritis?
We read with great interest the reports of macroscopic hematuria occurring hours following COVID-19 vaccination in patients with known IgAN1,2. We report two previously healthy individuals who presented with macroscopic hematuria shortly after COVID-19 vaccination and were diagnosed with Immunoglobulin A nephropathy (IgAN) and crescentic glomerulonephritis respectively.
- Occurrence of severe Covid-19 in vaccinated transplant patients
Vaccination plays a paramount role in the current Covid-19 pandemic response. While mRNA-based vaccines elicit a strong immune response in the general population, the immunization rates of immunocompromised patients – including solid organ transplant recipients – have not been specifically investigated in mRNA-1273 and BNT162b2 pivotal trials.1,2 This knowledge gap should be addressed urgently as these patients are highly prone to develop severe Covid-19.
- Evidence of Cell Mediated Immune response in kidney transplants with negative mRNA-1273 Antibody Response
Benotmane and colleagues have demonstrated that only 48% of renal transplant patients (RTxP) develop a serological response after vaccination with an mRNA-based SARS-COV2 vaccine1. Likewise, we reported that only 22% of RTxP develop anti-SARS-COV-2 IgG after vaccination with the mRNA-based SARS-COV-2 vaccine BNT162b2.
- A National Survey of Practice Patterns For Accepting Living Kidney Donors With Prior Covid-19
A critical question facing transplant programs is if, when and how to safely accept living kidney donors (LKD) who have recovered from COVID-19 infection. The purpose of the study is to understand current practices related to accepting these LKDs.
- Minimal Change Disease and AKI following the Pfizer-BioNTech COVID-19 Vaccine
A 77 year-old white male with 15-year history of type 2 diabetes mellitus without retinopathy received a first dose of the Pfizer-BioNTech vaccine on March 17, 2021. Past medical history included obesity, prior smoking and coronary artery disease. Baseline serum creatinine ranged 1.0 to 1.3 mg/dL with no proteinuria over the previous year. Outpatient medications included atorvastatin, aspirin, dulaglutide, empagliflozin, glipizide, losartan, metformin, and metoprolol.
- Use of Peritoneal Dialysis for Acute Kidney Injury during the COVID-19 Pandemic in New York City: A multicenter observational study
To demonstrate feasibility of acute peritoneal dialysis (PD) for acute kidney injury during the coronavirus disease 2019 (COVID-19) pandemic, we performed a multicenter, retrospective, observational study of 94 patients who received acute PD in New York City in the Spring of 2020.
- A case of gross hematuria and IgA Nephropathy Flare up following SARS-CoV-2 vaccination
We read with great interest L. Negrea, et al’s report of 2 cases of IgA nephropathy (IgAN) with gross hematuria following the Moderna vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 1. We also cared for a 52-year-old Asian female with prior biopsy-proven IgAN who developed gross hematuria within 24 hours of receiving a second dose of the Pfizer vaccine.
- Neutralizing antibody responses after SARS-CoV-2 infection in end-stage kidney disease and protection against reinfection
Patients with end-stage kidney disease (ESKD) represent a vulnerable group with multiple risk factors that are associated with poor outcomes following SARS-CoV-2 infection. Despite established susceptibility to infectious complications and the importance of humoral immunity in protection against SARS-CoV-2, few studies have investigated the humoral immune response to SARS-CoV-2 within this population.
- Timing of COVID-19 Vaccine in the setting of anti-CD20 Therapy: A Primer for Nephrologists
The corona virus disease-2019 (COVID-19) pandemic has continued to pose challenges to healthcare systems worldwide. This includes care of patients requiring immunosuppression, with significant disruption in healthcare delivery to these patients reported.1 The use of immunosuppression has been associated with high risk of severe COVID-19 disease.
- Weak anti-SARS-CoV-2 antibody response after the first injection of an mRNA COVID-19 vaccine in kidney transplant recipients
International recommendations on COVID-19 vaccine distribution have given priority to immunocompromised patients – including kidney transplant recipients (KTRs).1,2 Unfortunately, this guidance has been released without inclusion of this clinical population in vaccine clinical trials. In an effort to shed light on the efficacy and safety of an mRNA COVID-19 vaccine in KTRs, this preliminary study was undertaken to investigate the anti-SARS-CoV-2 antibody response after the first injection.
- Longevity of SARS-CoV-2 immune responses in hemodialysis patients and protection against reinfection
Patients with end stage kidney disease receiving in-center hemodialysis (ICHD) have had high rates of SARS-CoV-2 infection. Following infection, patients receiving ICHD frequently develop circulating antibodies to SARS-CoV-2, even with asymptomatic infection. Here, we investigated the durability and functionality of the immune responses to SARS-CoV-2 infection in patients receiving ICHD.
- Gross Hematuria Following Vaccination for SARS-CoV2 in Two Patients with IgA Nephropathy
Several of the SARS-CoV2 vaccines use a nucleoside-modified, purified mRNA lipid nanoparticle-encapsulated platform. Compared to traditional inactivated viral and adjuvanted protein vaccines, this RNA platform elicits far higher neutralizing antibody titers, stronger antigen-specific CD4+ and CD8+ T cells responses, and stronger germinal center B and TFH cell activation in experimental animals.
- From confusion to clarity: RAS blockade in patients hospitalized with COVID-19
The public, scientific, and medical community continues to face unprecedented challenges in dealing with all aspects of the coronavirus disease 2019 (COVID-19) pandemic. Intense debate and research continue to focus on determining why some individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, are asymptomatic or mildly symptomatic, whereas others manifest severe disease, which is often fatal.
- Impact of the COVID-19 pandemic on training, morale and well-being amongst the UK renal workforce
When the COVID-19 pandemic reached the United Kingdom (UK) in early 2020, 1 adaptive reconfigurations were rapidly implemented within healthcare teams, including the renal workforce. Widespread changes included increased shift patterns, redeployment of staff, and the return of individuals undertaking academic secondments to clinical work. 2 Furthermore, vulnerable staff were advised to ‘shield’, 3 triggering a redistribution of responsibilities between those compelled to work remotely and those on the frontline. We sought to characterise the impacts of these changes on the UK renal workforce.
- Acute kidney injury in pediatric patients hospitalized with acute COVID-19 and Multisystem Inflammatory Syndrome in Children associated with COVID-19
This study describes the incidence, associated clinical characteristics and outcomes of acute kidney injury in a pediatric cohort with COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C). We performed a retrospective study of patients 18 years of age and under admitted to four New York hospitals in the Northwell Health System interned during the height of the COVID-19 pandemic, between March 9 and August 13, 2020. Acute kidney injury was defined and staged according to Kidney Disease: Improving Global Outcomes criteria.
- Zero healthcare-associated respiratory viral infections: impact of enhanced infection prevention on a renal unit during the COVID-19 pandemic
We read with interest the study by Thaunat et al. that identified significant excess mortality attributed to COVID-19 amongst dialysis patients. Indeed, the COVID-19 pandemic has provided the impetus for the introduction of strategies to optimise protection of hemodialysis patients from SARS-CoV-2.
- Panic in the Pandemic: When Should Kidney Transplant Programs Close?
Pandemics greatly interfere with overall health care delivery as resources are diverted to combat the crisis. Kidney transplantation programs were closed temporarily during the COVID-19 pandemic. Given the critical shortage of organs, their short shelf life and their overall importance to improving length and quality of life for those with kidney disease, this analysis examines the impact of discarding deceased donor organs.
- Kidney Disorders as Serious Adverse Drug Reactions of Remdesivir in Covid-19: A Retrospective Case-Non case Study
Remdesivir is a novel adenosine-like nucleotide analogue, representing the first drug approved for coronavirus disease 2019 (Covid-19), albeit an uncertain clinical relevance. In clinical trials and case series, acute kidney injury (AKI), including renal replacement, have been frequently reported.1,2 Although causality is debatable, kidney injuries especially proximal tubular epithelial cell necrosis have also been observed in animal studies during remdesivir development.
- COVID-19 vaccination acceptance and hesitancy in dialysis staff: First results from New York City
Broad adoption of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is key to successfully fighting the spread of coronavirus disease 2019 (COVID-19). When fallen ill with COVID-19, in-center hemodialysis patients are at particularly high risk for morbidity and mortality.1,2 Therefore, it is of utmost importance to attain high vaccination rates in both dialysis patients and staff.
- The urgent need to vaccinate dialysis patients against SARS-CoV-2: A call to action
The COVID-19 pandemic is causing extreme stress to many health systems and an ever-mounting death toll. Out of the darkness of the last 14 months comes a beacon of hope in the form of multiple SARS-Cov-2 vaccines. To best utilize this precious resource, we must efficiently deploy vaccination to high-risk groups.
- GBM nephritis – Crescentic renal inflammation and immunosuppressive intervention in the time of the SARS-CoV-2 pandemic
the diagnosis and management of autoimmune disorders is challenging in the current pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we describe the case of a patient with anti-glomerular-basement-membrane (GBM) disease complicated by a SARS-CoV-2 infection to highlight the importance of appropriate immunosuppression and individualized care in respect of these two disease processes.
- Systematic review of safety and efficacy of COVID-19 vaccines in patients with kidney disease
Chronic kidney disease (CKD) affects 37 million or 15% of the US population and 2 in every 1000 Americans are on dialysis or living with a kidney transplant. In 2020 COVID-19 infection became the third leading cause of death for persons 45 through 84, and individuals with kidney disease are recognized as being at higher risk for severe complications from COVID-19 infection.
- Decreasing Incidence of AKI in Patients with COVID-19 critical illness in New York City
Reports from the United States suggest that acute kidney injury (AKI) frequently complicates COVID-19, but understanding of AKI risks and outcomes is incomplete. Additionally, whether kidney outcomes have evolved during the course of the pandemic is unknown.
- COVID-19 associated graft loss from renal infarction in a kidney transplant recipient
An increasing number of reports have recognized the contribution of COVID-19 to the development of acute kidney injury [AKI] and its impact on morbidity and mortality in hospitalised patients. Of concern is the high rate of AKI reported in kidney transplant recipients infected with SARS-CoV-2 compared to the general population
- Critical illness and systemic inflammation are key risk factors of severe AKI in patients with COVID-19
Acute kidney injury (AKI) is an important complication in COVID-19, but its precise etiology has not fully been elucidated. Insights into AKI mechanisms may be provided by analyzing the temporal associations of clinical parameters reflecting disease processes and AKI development.
- High rates of long-term renal recovery in survivors of COVID-19-associated acute kidney injury requiring kidney replacement therapy
While acute kidney injury requiring kidney replacement therapy (AKI-KRT) is an important and severe complication in COVID-19 patients, data on its long-term outcomes are currently limited. Previous studies reported that 65-70% of patients with AKI-KRT had recovered from dialysis dependency at the time of hospital discharge.
- Two episodes of SARS-CoV-2 infection in a patient on chronic hemodialysis. A note of caution
Knowledge about COVID-19 patterns in frail patients is still incomplete. Patients on chronic haemodialysis have a high risk both of infection and of severe disease because of their fragility and unavoidable health-care related contacts.
- SEX MATTERS – COVID-19 IN KIDNEY TRANSPLANTATION
The COVID-19 pandemic (caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)) has led to a dramatic loss of lives and presented an unprecedented challenge to public health and economic systems worldwide. To date, over 58.7 million people globally have been infected with the SARS-CoV-2 virus, and over 1.39 million individuals have died (https://covid19.who.int/ accessed November 24, 2020). Among patients with chronic illness, including patients with kidney failure and those with kidney transplants, the impact is even more substantial
- Acute kidney injury requiring RRT during the COVID-19 pandemic: What are our options for treating it in Latin America?
Within a month after the first case was reported on February 2020 in Brazil, all countries in Latin America had reported cases of the novel coronavirus disease 2019 (COVID-19); Brazil, Argentine and Colombia were the most affected countries, with 9,467,320 cases among them reported by early December. Increased poverty, limited water access, poor sanitation, and distrust in governments are important factors that have affected the transmission and have facilitated COVID-19 outbreaks in Latin America.
- The impact of a national surgical mask wearing policy on COVID-19 transmission in Haemodialysis units in the Republic of Ireland.
In late 2019 a novel betacoronavirus named SARS-CoV-2 was reported in China, and subsequently spread rapidly to cause a global pandemic. SARS-CoV-2 is primarily spread through respiratory droplets typically released by coughing, sneezing, breathing or speaking and may be aerosolized by singing, ventilation or the use of nebulisers.
- Characteristics and Outcomes of COVID-19 in Patients with ANCA associated vasculitis
The Coronavirus disease 2019 (COVID-19) pandemic has not only stressed medical systems with its acute presentations, but also has conferred an additional permutation to the management of various established diseases. This includes patients with autoimmune disease requiring immunosuppression. The optimal management of immunosuppression during the pandemic and in those with acute infection still remains a matter of debate.
- Use of Remdesivir in Patients with Covid-19 on Hemodialysis – A Study Of Safety and Tolerance
There is scarce data regarding the use of Remdesivir in Severe acute respiratory distress syndrome Corona virus 2 (SARS CoV2) patients with End Stage Renal Disease (ESRD) as the Food and Drug Administration (FDA) cautions against its use in patients with estimated glomerular filtration rate(eGFR) less than 30ml/min/1.73m2 unless the potential benefits outweigh potential risks.
- Acute Peritoneal Dialysis with Percutaneous Catheter Insertion for COVID-19-associated Acute Kidney Injury in Intensive Care: Experience from a UK Tertiary Centre
During the COVID-19 pandemic in 2020, high rates of acute kidney injury (AKI) in critically unwell patients are being reported, leading to increased demand for renal replacement therapy (RRT). Providing RRT for this large number of patients is proving challenging and so alternatives to continuous renal replacement therapies (CRRT) in intensive care units (ICU) are needed.
- New Answers to Old questions: Wait List versus Transplant Outcomes in the COVID-19 Era
The Covid-19 pandemic has dramatically affected health care systems and health outcomes around the world. Transplantation has responded with critical changes to the delivery of transplant services for patients awaiting organ transplants as well as for the larger group of previously transplanted recipients (1, 2, 3). The complex clinical nature of these patients as well as the complicated infrastructure required to successfully deliver care to these patients has made the vulnerability of transplant systems apparent to all of us who work in this field.
- In-house Production of Dialysis Solutions to Overcome Challenges during the COVID-19 Pandemic
The coronavirus disease 2019, known as COVID-19, has affected >30 million people globally, leading to more than 900,000 deaths. Many healthcare systems have faced significant challenges in providing care for overwhelming numbers of patients due to resource constraints. The United Kingdom (UK) is one of the most affected countries, and by September 17th, 2020, 381,614 people were confirmed COVID-19 positive, 41,705 had died, and 13,710 had been admitted to critical care.1,2 Acute kidney injury (AKI) was reported in 25-78% of critically ill patients and approximately 25% required renal replacement therapy (RRT).
- Informing the risk of kidney transplantation versus remaining on the wait list in the COVID-19 era
There is limited data pertaining to comparative outcomes of remaining on dialysis versus kidney transplantation as the threat of COVID-19 remains. This study aims to delineate the differential risks involved using serological methods to help define exposure rates.
- Tubular Epithelial and Peritubular Capillary Endothelial Injury in COVID-19 AKI
Multiple reports describe the respiratory system involvement in coronavirus disease 2019 (COVID-19), but in patients that require hospitalization concurrent renal dysfunction is common. In a large study, more than 36% of patients developed acute kidney injury (AKI), and of those, 14.3% required renal replacement therapy (RRT) S1. Development of AKI occurs early, is temporally associated with acute respiratory failure, and carries worse overall prognosis.
- COVID-19 and kidney transplantation: A systematic review
Kidney transplant recipients are at increased susceptibility to many viral infections leading to justifiable anxiety about the effects of COVID-19.
- IMPact of the COVID-19 epidemic on the moRTAlity of kidney transplant recipients and candidates in a French Nationwide registry sTudy (IMPORTANT).
End stage kidney disease increase the risk of COVID-19 related death but how the kidney replacement strategy should be adapted during the pandemic is unknown. Chronic hemodialysis makes social distancing difficult to achieve. Alternatively, kidney transplantation could increase the severity of COVID-19 due to therapeutic immunosuppression and contribute to saturation of intensive care units.
- Phase 3 Randomized Controlled Trials on Exclusion of Participants with Kidney Disease in COVID-19
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has a range of presentations and outcomes from asymptomatic carriage to acute respiratory distress syndrome and death. The incidence of acute kidney injury (AKI) is high among patients with COVID-19. Moreover, patients with CKD, who make up over 10% of the global population, are at high risk for severe COVID-19
- Significant impact of COVID-19 on organ donation and transplantation in a low-prevalence country: Australia
The incidence and impact of COVID-19 has varied enormously across the globe. The pandemic has negatively impacted organ donation and transplantation in countries that have experienced high rates of infection, including the USA, France and the UK, all reporting greater than 50% reductions in transplant activity. Australia has experienced a significantly lower incidence of COVID-19. Despite this, the impact on organ transplantation has been significant.
- A Kidney International “Journal of the COVID-19 Year” in Kidney Transplantation
The global COVID-19 pandemic’s impact on kidney transplant recipients and transplantation programs in the calamitous months of February to June 2020, the Northern Hemisphere Spring to Summer, is represented in articles published in the December issue of Kidney International.
- COVID-19 infection in kidney transplant recipients at the epicenter of pandemics
We investigated the prevalence and clinical outcomes of COVID-19 in recipients of kidney transplants in the Bronx, New York, one of the epicenters of the pandemic. Between March 16 and June 2, 2020, 132 kidney transplant recipients tested positive by SARS-CoV-2 RT-PCR. From May 3 to July 29, 2020, 912 kidney transplant recipients were screened for SARS-CoV-2 IgG antibodies during routine clinic visits, of which 16.6% tested positive.
- Registry reports in COVID-19 patients: juggling with big data, poor data, and no data
We read with great interest the paper by Caillard et al. recently accepted in the Journal, which is an interesting addition to the burgeoning COVID-19 literature. However, we noted a discrepancy between the 426 kidney transplant patients reported to the registry and the 279 cases presented, which corresponds to a third of all patients.
- Response to “Registry reports in COVID-19 patients: juggling with big data, poor data, and no data”
We thank Søfteland and coworkers for their interest in our registry based-study focusing on COVID-19 in kidney transplant recipients. First, the authors lament that a discrepancy exists in the number of patients reported in the “Introduction” section (n=426) and those included in the final analysis (n=279).
- COVID-19 in Dialysis Patients: Outlasting and Outsmarting a Pandemic
COVID-19 has affected dialysis patients and dialysis patient care worldwide. In this issue of Kidney International, three reports highlight the disproportionately severe impact of COVID-19 on dialysis patients, noting its high prevalence, particularly among in-center dialysis patients.
- Ethics of kidney care in the era of COVID-19
The COVID-19 pandemic presents significant challenges for health systems globally, including substantive ethical dilemmas that may pose specific concerns in the context of care for people with kidney disease. Ethical concerns may arise as changes to policy and practice impact on the ability of all health professionals to fulfil their ethical duties towards their patients in providing best practice care.
- SARS-CoV-2 receptor networks in diabetic and COVID-19 associated kidney disease
COVID-19 morbidity and mortality are increased in patients with diabetes and kidney disease via unknown mechanisms. SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) for entry into host cells. Since ACE2 is a susceptibility factor for infection, we investigated how diabetic kidney disease and medications alter ACE2 receptor expression in kidneys. Single cell
- Oxalate Nephropathy Caused by Excessive Vitamin C Administration in 2 Patients With COVID-19
Kidney dysfunction is frequently reported in patients with coronavirus disease 2019 (COVID-19). A recent large cohort study described an incidence of acute kidney injury (AKI) of 36% in patients who were hospitalized with COVID-19; AKI (often mild) was temporally linked with respiratory failure and associated with a poor prognosis.
- Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe
The aim of this study was to investigate 28-day mortality after COVID-19 diagnosis in the European kidney replacement therapy population. In addition, we determined the role of patient characteristics, treatment factors, and country on mortality risk using ERA-EDTA Registry data on patients receiving kidney replacement therapy in Europe between February 1, 2020 and April 30, 2020.
- Successful Simultaneous Pancreas and Kidney Transplant in a Patient Post-COVID-19 Infection
The Coronavirus Disease-2019 (COVID-19) pandemic has slowed down the solid organ transplantation worldwide. Although, we have heard of few solid organ transplants having been performed in patients recovered from COVID-19 infection, none has been reported yet. We present a patient who underwent a simultaneous pancreas and kidney transplantation (SPK) after recovering from COVID-19 and is doing well close to 2 months post-transplantation.
- Proximal tubular dysfunction in patients with COVID-19: what have we learnt so far?
Recent studies have reported a variety of urine abnormalities in patients hospitalized due to SARS-CoV-2 infection. In a single center study from Belgium, Werion et al., now present a concise investigation of tubular dysfunction in COVID-19 patients identifying potential risk factors for increased disease severity. These data complement current evidence regarding SARS-CoV-2 presence and potential infection in the kidney.
- Anti–glomerular basement membrane disease during the COVID-19 pandemic
Anti–glomerular basement membrane (anti-GBM) disease is a rare autoimmune small-vessel vasculitis. The recent confirmation of spatial and temporal clustering of cases suggests that environmental factors, including infection, may trigger disease in susceptible individuals.
- Coronavirus disease 2019 (COVID-19) hospitalized patients with acute kidney injury treated with acute peritoneal dialysis do not have infectious peritoneal dialysis effluent
Acute peritoneal dialysis (PD) has been used in coronavirus disease 2019 (COVID-19) as an alternative to intermittent hemodialysis or continuous renal replacement therapy to mitigate the overwhelming demand for dialysis. Liters of PD effluent are discarded in the sewerage system on a daily basis by both patients and medical institutions performing PD. Detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the peritoneal waste of a COVID-19 infected patient with end-stage kidney disease was previously reported.
- Reduced prescription tacrolimus use: a cross-sectional analysis of England’s national prescription statistics during the COVID-19 pandemic, by region
Many UK transplant centers currently provide restricted access due to coronavirus disease 2019 (COVID-19). Full-year total organ transplants numbered 3997 in 2019–2020 versus 4183 in the previous year, a fall of 4.45%
- COVID-19 and ESRD: Entering a New Era of Uncertainty
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus disease 2019 [COVID-19]) pandemic has raised our awareness of the susceptibility of certain members of the population to this serious and often fatal infection. Across the globe, more than 5.8 million cases have been confirmed and more than 360,000 deaths reported as of the end of May 2020. Some areas have been particularly hard hit (the so-called epicenters of the pandemic) and certain populations within these epicenters have been particularly affected. Witness to this is those living in skilled nursing facilities (SNFs).
- Hypercoagulability and Anticoagulation in Patients With COVID-19 Requiring Renal Replacement Therapy
Severe acute respiratory coronavirus 2 (SARS-CoV2) and the resulting acute respiratory distress syndrome (coronavirus disease 2019 [COVID-19]) is responsible for a worldwide pandemic, with more than 10 million cases reported as of June 28, 2020.S1 Although severe disease requiring hospitalization is characterized by pneumonia and respiratory failure, a significant proportion also develop acute kidney injury.
- Peritoneal Dialysis for Acute Kidney Injury During the COVID-19 Pandemic in New York City
The coronavirus disease 2019 (COVID-19) pandemic resulted in extraordinary increase in the number of patients requiring renal replacement therapy (RRT), high rate of clotting in continuous RRT (CRRT) circuits, limited dialysis supplies and shortages of dialysis staff due to illness or quarantine. This created an opportunity to use peritoneal dialysis (PD) for acute kidney injury (AKI).
- COVID-19 in Patients on Maintenance Dialysis in the Paris Region
Coronavirus disease 2019 (COVID-19) represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate, and prognostic factors in these patients have not been well established.
- The Adverse Effect of COVID Pandemic on the Care of Patients With Kidney Diseases in India
The coronavirus disease 2019 (COVID-19) pandemic has affected the care of patients with noncommunicable diseases, including those suffering from kidney-related ailments. Many parts of the world, including India, adopted lockdown to curb community transmission of disease. The lockdown affected transportation, access to health care facilities, and availability of medicines and consumables as well as outpatient and inpatient services. We aimed to analyze the effect of lockdown imposed due to the COVID-19 pandemic on the care of patients with kidney diseases in India.
- SARS-CoV-2 Virions or Ubiquitous Cell Structures? Actual Dilemma in COVID-19 Era
Several reports have suggested ultrastructural evidence of direct infection of different types of kidney cells by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in postmortem analysis and kidney biopsy specimens in patients with proven viral reverse-transcriptase polymerase chain reaction (RT-PCR) from nasopharyngeal smears. Detection of supposed viral particles by transmission electron microscopy (TEM) was used as sufficient evidence for viral invasion of renal tissue but data regarding detection of viral RNA or other valuable methods for viral detection of kidney specimens were missing.
- Transient Renal Tubular Syndromes Associated With Acute COVID-19 Disease
We report 2 transient renal tubular syndromes associated with coronavirus disease 2019 (COVID-19).A 47-year-old patient in a neurorehabilitation unit was diagnosed with COVID-19 following onset of respiratory symptoms and pyrexia, confirmed by reverse transcriptase polymerase chain reaction. Ten days later, he developed hypernatremia with an acute kidney injury. He was exclusively fed by percutaneous endoscopic gastrostomy tube.
- An initial report from the French SOT COVID Registry suggests high mortality due to Covid-19 in recipients of kidney transplants.
Notwithstanding the ongoing coronavirus disease-2019 (Covid-19) pandemic, information on its clinical presentation and prognosis in recipients of a kidney transplant remain scanty. The aim of this registry-based observational study was to explore characteristics and clinical outcomes of recipients of kidney transplants included in the French nationwide Registry of Solid Organ Transplant Recipients with Covid-19
- Challenges in setting up point-of-care hemodialysis in a COVID-19 care facility: Lessons from a limited-resource setting
Dialysis care is one amongst the many health-care activities to be severely affected by coronavirus disease 2019 (COVID-19). Further, health-care facilities in limited-resource settings are challenged with unique problems warranting distinct strategies to combat this crisis. Our administrator was summoned to set up a state-of-the art facility for managing infected patients in a jiffy
- De Novo ANCA-associated Vasculitis with Glomerulonephritis in COVID-19
Coronavirus Disease 2019 (COVID-19) is a pandemic, caused by a novel coronavirus that has been identified to belong to the beta-coronavirus family.1 As the COVID-19 pandemic continues to evolve, more aspects of this illness are being defined and described. In the US, the incidence of acute kidney injury (AKI) in patients hospitalized with COVID-19, has been reported to be around 37%.2 Different autopsy and kidney biopsy series have revealed acute tubular injury (ATI) to be the most common renal pathology lesion in these patients.
- IgA Vasculitis with Nephritis (Henoch-Schönlein purpura) in a COVID-19 patient
In December 2019, a series of pneumonia cases of unknown etiology, which were epidemiologically linked to a seafood market, was reported in Wuhan, Hubei province, China. The disease has rapidly spread around the world, becoming a global pandemic. A coronavirus, which was named 2019 novel coronavirus (2019-nCov), was isolated from respiratory tract samples1 and later identified as SARS-CoV-2. The name of the disease was officially changed to Coronavirus Disease 2019 (COVID-19).
- Dashboards to facilitate nephrology disaster planning in the COVID-19 era
The emergence of the coronavirus disease 2019 (COVID-19) pandemic has placed tremendous stress on health care systems. While there was early recognition of the need for rapid upscaling and sourcing for ventilatory support, the need for renal replacement therapy (RRT) resource planning due to the high incidence of acute kidney injury (AKI) was not widely anticipated.
- Outcomes of patients with end-stage kidney disease hospitalized with COVID-19
Given the high risk of infection-related mortality, patients with end-stage kidney disease (ESKD) may be at increased risk with COVID-19. To assess this, we compared outcomes of patients with and without ESKD, hospitalized with COVID-19. This was a retrospective study of patients admitted with COVID-19 from 13 New York. hospitals from March 1, 2020, to April 27, 2020, and followed through May 27, 2020.
- SARS-CoV-2 Causes a Specific Dysfunction of the Kidney Proximal Tubule
LCoronavirus disease 2019 (COVID-19) is commonly associated with kidney damage, and the angiotensin converting enzyme 2 (ACE2) receptor for SARS-CoV-2 is highly expressed in the proximal tubule cells. Whether patients with COVID-19 present specific manifestations of proximal tubule dysfunction remains unknown. To test this, we examined a cohort of 49 patients requiring hospitalization in a large academic hospital in Brussels, Belgium.
- Acute kidney injury associated with lopinavir/ritonavir combined therapy in patients with COVID-19
Lopinavir and low-dose ritonavir are associated in a fixed-dose combination protease inhibitor therapy (LPV/RTV), indicated against human immunodeficiency virus infection (HIV) and acquired immune deficiency syndrome. The recent outbreak of severe acute respiratory syndrome coronavirus 2 infections causing coronavirus disease 2019 (Covid-19) has rekindled the interest in LPV/RTV, following preclinical studies.
- Steroids: A Therapeutic Option for COVID-19 Pneumonia Patients With ESRD?
Alberici et al.1 proposed in a recent review some therapeutic approaches for patients with end-stage renal disease and infected with coronavirus disease 2019 (COVID-19). They notably suggest the use of steroids during the inflammatory phase of the disease, even if their efficacy is currently being debated
- Treatment Impact on COVID-19 evolution in hemodialysis patients
We retrospectively studied 248 patients on maintenance hemodialysis (MHD) affected by COVID-19 (1) in 19 private and academic MHD centers of the Paris, France area.
- Peritoneal Dialysis for Acute Kidney Injury during the COVID-19 Pandemic in New York City
The Coronavirus disease 2019 (COVID-19) pandemic resulted in extraordinary increase in the number of patients requiring Renal replacement Therapy (RRT), high rate of clotting in Continuous Renal Replacement Therapy (CRRT) circuits, limited dialysis supplies and shortages of dialysis staff due to illness or quarantine.
- Epidemiological, Clinical, and Immunological Features of a Cluster of COVID-19–Contracted Hemodialysis Patients
The outbreak of highly contagious coronavirus disease 2019 (COVID-19) has posed a serious threat to human life and health, especially for those with underlying diseases. However, the impact of COVID-19 epidemic on hemodialysis (HD) centers and HD patients has not been reported.
- Kidney International and the COVID-19 infection
The Editorial Team of Kidney International would like to reassure our readership that we will continue to bring you highquality information throughout the COVID19 pandemic to help all of us deal with the crisis and provide high-quality care to our patients.
- Coronavirus disease 2019 (COVID-19) hospitalized patients with acute kidney injury treated with acute peritoneal dialysis do not have infectious peritoneal dialysis effluent
Acute peritoneal dialysis (PD) has been used in coronavirus disease 2019 (COVID-19) as an alternative to intermittent hemodialysis or continuous renal replacement therapy to mitigate the overwhelming demand for dialysis.
- Thrombotic microangiopathy in a patient with COVID-19
We describe a patient with coronavirus disease 2019 (COVID-19) and clinically significant kidney biopsy-proven thrombotic microangiopathy.
- Rapid resolution of cytokine release syndrome and favorable clinical course of severe COVID-19 in a kidney transplant recipient treated with tocilizumab
Immunomodulatory drugs, such as tocilizumab, hold promise for the management of cytokine release syndrome in coronavirus disease 2019 (COVID-19).
- Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in Brescia, Italy
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease (COVID-19), is a major pandemic challenging health care systems around the world.
- Hypercoagulability and anticoagulation in patients with COVID-19 requiring renal replacement therapy
Severe acute respiratory coronavirus 2 (SARS-CoV2) and the resulting acute respiratory distress syndrome (COVID-19) is responsible for a worldwide pandemic, with over 10 million cases reported as of 28th June 2020.
- COVID-19 and ESRD: Entering a New Era of Uncertainty
The SARS-CoV-2 (COVID-19) pandemic has raised our awareness of the susceptibility to certain members of the population to this serious and often fatal infection.
- The Cumulative Rate of SARS-CoV-2 Infection in Chinese Hemodialysis Patients
There is a paucity of information regarding SARS-CoV-2 infection in patients undergoing maintenance hemodialysis. We aimed to estimate the cumulative attack rate of SARS-CoV-2 in hemodialysis patients in China using a serological test.
- COVID-19 in patients on maintenance dialysis in the Paris Region
COVID-19 represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate and prognostic factors in these patients have not been well established.
- SARS-Cov-2 virions or ubiquitous cell structures? Actual dilemma in COVID-19 era
Several reports have suggested ultrastructural evidence of direct infection of different types of kidney cells by SARS-CoV-2 in post-mortem analysis and kidney biopsy specimens in patients with proven viral RT-PCR from nasopharyngeal smears. Detection of supposed viral particles by transmission electron microscopy (TEM) was used as sufficient evidence for viral invasion of renal tissue but data regarding detection of viral RNA or other valuable methods for viral detection of kidney specimens were missing
- Hydroxychloroquine-associated Hypoglycemia in Hemodialysis Patients with COVID-19
Coronavirus Disease 2019 (COVID-19) is a global health problem, but optimal treatment modality is unclear. The treatment protocol for patients with COVID-19 consists of azithromycin, hydroxychloroquine (HCQ), and low-molecular-weight heparin in our center.
- Transient Renal Tubular Syndromes Associated with Acute COVID-19 Disease
We report two transient renal tubular syndromes associated with COVID19 disease.
- Interleukin 6 levels after tocilizumab administration in transplant recipients with COVID-19
It is with great interest we read the article by Gautier-Vargas and colleagues that reported favorable clinical response with tocilizumab in a kidney transplant recipient with severe coronavirus disease 2019 (COVID-19)
- The adverse effect of COVID pandemic on the care of patients with kidney diseases in India
The Coronavirus disease-19 (COVID-19) pandemic has affected the care of patients with non-communicable diseases, including those suffering from kidney-related ailments. Many parts of the world, including India, adopted lockdown to curb community transmission of disease. The lockdown affected transportation, access to healthcare facilities, availability of medicines, and consumables as well as out and inpatient services. We aimed to analyze the effect of lockdown imposed due to COVID-19 pandemic on the care of patients with kidney diseases in India
- Dashboards to facilitate nephrology disaster planning in the COVID-19 era
The emergence of the Coronavirus Disease 2019 (COVID-19) pandemic has placed tremendous stress on healthcare systems. While there was early recognition of the need for rapid upscaling and sourcing for ventilatory support, the need for renal replacement therapy (RRT) resource planning due to the high incidence of acute kidney injury (AKI) was not widely anticipated.
- Reduced prescription tacrolimus use: A cross-sectional analysis of England’s national prescription statistics during COVID-19 pandemic by region
Many United Kingdom transplant centres currently provide restricted access due to COVID-19. Full-year total organ transplants were 3997 in 2019/20 versus 4183 in the previous year, a fall of 4.45%
- A Systematic Review and Meta-Analysis Of Outcomes for Patients with COVID-19 and Acute Kidney Injury
There is limited data on the association of kidney dysfunction with prognosis in COVID-19, and the extent to which acute kidney injury (AKI) predisposes patients to severe illness and inferior outcomes is unclear. We aim to assess the incidence of AKI among patients with COVID-19 and examine their associations with patient outcomes as reported in the available literature thus far.
- A view from the front line of the COVID-19 war
Just a few weeks ago, I was looking at kidney biopsy slides through the microscope. As a nephrologist with a special interest in renal histopathology, I never thought I would soon find myself at the front line in the coronavirus disease 2019 (COVID-19) pandemic.
- COVID-19 in dialysis patients: adding a few more pieces to the puzzle
Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19) and its complications, owing to the presence of multiple comorbid conditions. The logistical aspects within a dialysis facility further increase the risk of disease transmission
- A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection
The SARS-CoV-2 epidemic is pressuring healthcare systems worldwide. Disease outcomes in certain subgroups of patients are still scarce, and data are needed. Therefore, we describe here the experience of four dialysis centers of the Brescia Renal COVID Task Force.
- COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis therapy than in the general population.
- Preparedness of Kidney Replacement Therapy in the Critically Ill During COVID-19 Surge
The devastating and rapidly spreading coronavirus disease 2019 (COVID-19) pandemic has challenged the health care system worldwide. COVID-19 primarily affects the lungs and is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, multiple other organ systems also may be affected, including kidneys, blood (hypercoagulability), brain, and heart.
- Delivering dialysis during the COVID-19 outbreak: Strategies and outcomes
Haemodialysis (HD) patients are at increased risk of COVID-19 infection. Although all dialysis patients meet government criteria for shielding, only those on home treatment can comply. Patients attending incentre HD units represent a large and vulnerable group, who are unable to rigorously adhere to this advice
- The case of Complement activation in COVID-19 multiorgan impact
The novel coronavirus disease COVID-19 originates in the lungs, but may extend to other organs, causing, in severe cases, multiorgan damage, including cardiac injury and acute kidney injury. In severe cases, the presence of kidney injury is associated with increased risk of death, highlighting the relevance of this organ as a target of SARS-CoV-2 infection.
- COVID-19 outbreak in a large hemodialysis centre in Lombardy, Italy
On December 31, 2019, China reported the first cases of pneumonia of unknown cause that would later be identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (1-3). SARS-CoV2 rapidly spread, resulting in a pandemic, and as of April 10, 2020 there were almost 1.6 million confirmed cases were reported worldwide, with approximately 97,200 deaths.
- Kidney biopsy findings in a critically ill COVID-19 patient with dialysis-dependent acute kidney injury: a case against “SARS-CoV-2 nephropathy”
It is unclear whether in patients with SARS-CoV-2 infection, acute kidney injury (AKI) results from direct infection of the kidneys or from complications arising in the course of COVID-19. Reports of urinary abnormalities in COVID-19 patientsS1, positive staining of tubules with viral antigens and complement components in one autoptic series1, visualization of viral particles in tubular epithelial cells and podocytes on ultrastructural examination in another2, and isolation of SARS-CoV-2 in urineS2,S3, raised the possibility of a “SARS-CoV-2 nephropathy”.
- SARS-CoV2 in the peritoneal waste in a patient treated with peritoneal dialysis
We describe for the first time the detection of SARS-CoV2 in the peritoneal waste of a patient with COVID19 and end-stage-kidney-disease on peritoneal dialysis
- Acute Kidney Injury In Patients Hospitalized With Covid-19
The rate of acute kidney injury (AKI) associated with patients hospitalized with Covid-19, and associated outcomes are not well understood. This study describes the presentation, risk factors and outcomes of AKI in patients hospitalized with Covid-19.
- De-isolation of COVID-19– positive hemodialysis patients in the outpatient setting: Q1 a single-center experience
The advice for patients presenting with COVID-19 symptoms is to self-isolate for 7 days after the onset of symptoms for the individual case and 14 days for the household.1 Dialysis patients can be considered as immunocompromised and display a decreased ability to develop seroconversion to infectious diseases.
- A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection
The SARS-CoV-2 epidemic is pressuring health care systems worldwide. Disease outcomes in certain subgroups of patients are still scarce, and data are needed. The report describes the experience of four dialysis centers of the Brescia Renal COVID task force.
- COVID-19: Clinical course and outcomes of 36 maintenance hemodialysis patients from a single center in Spain.
SARS-CoV-2-pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), even less in patients on maintenance hemodialysis (MHD) therapy than in the general population.
- Autophagy inhibition by chloroquine and hydroxychloroquine could adversely affect AKI and other organ injury in critically ill patients with COVID-19
We read the letter by Izzedine et al (1) with great interest especially the discussion of renal adverse effects of drug treatment options for COVID-19. We would like to draw particular attention to the potential adverse effect of chloroquine and hydroxychloroquine, the lysosomotropic antimalarial drugs that may inhibit the infection of SARS-CoV-2 by reducing the entry and replication of the virus.
- Multivesicular Bodies (MVB) Mimicking SARS-CoV-2 in patients without COVID-19
It is now well known that patients with novel coronavirus disease (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) commonly have kidney complications, including acute kidney injury, proteinuria, and hematuria
- Visualization of Putative Coronavirus in Kidney
We read with concern the articles that report the presence of coronavirus in kidney based on electron microscopic evidence (1, 2). Neither article, in fact, demonstrates the presence of coronavirus in the kidney.
- Acute Kidney Injury Due to Collapsing Glomerulopathy Following COVID-19 Infection
Article presents a case of CG associated with COVID-19 in the initial days of the epidemic’s spread to New York City, and summarizes that, “As we learn more about the renal manifestations of COVID-19, we should keep in mind the possibility of CG among COVID-19 patients with proteinuria and acute kidney injury, even among those with mild respiratory disease.”
- Adding insult to injury: kidney replacement therapy during COVID-19 in India
The report describes the unique hardships confronted by maintenance in-center hemodialysis patients and kidney transplant recipients in India during the current lockdown period.
- Letter to the Editor: Collapsing glomerulopathy in a COVID-19 patient
The first available reports indicate that renal involvement is relatively frequent in patients with novel coronavirus disease (COVID-19) due to the emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the exact mechanisms underlying renal injury in patients with COVID-19 are unclear as renal pathology data are lacking.
- Early Experience with COVID-19 in Kidney Transplantation
- COVID-19 infection in kidney transplant recipients
- A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia
- Collapsing Glomerulopathy in a Patient with Coronavirus Disease 2019 (COVID-19)
This case raises the question of whether people of African descent with high-risk APOL1 genotype (presence of two risk alleles) could be at increased risk of kidney disease in the setting of COVID-19.
- Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China
- Managing the COVID-19 Pandemic: International Comparisons in Dialysis Patients
As new information appears, updated guidance produces many similarities, and some differences in these guidance documents, in part deriving from regional and population differences. This article reviews guidance for detecting and mitigating COVID-19 infections in dialysis patients, noting where there is universal agreement and where there are differences.
- Blockade of SARS-CoV-2 infection by recombinant soluble ACE2
Viruses use specific host-cell plasma membrane molecules as receptors to enter the cell. SARS-CoV-2, the coronavirus responsible for the current COVID-19 pandemic, is believed to bind mainly or exclusively to angiotensin-converting enzyme 2 (ACE2). ACE2 activity per se does not seem to be involved in infectivity, but its role in pulmonary, cardiac and kidney function has putative consequences for disease severity.
- The Novel Coronavirus 2019 epidemic and kidneys
- Could ferritin help the screening for COVID-19 in hemodialysis patients?
Screening for COVID-19 in hemodialysis centers is crucial to then isolate infected patients and protect non-infected patients. Ferritin could be a helpful, available and easy to use screening tool for the disease, although we believe that more research is still needed.
- SARS-CoV-2 Infection in Hospitalized Patients with Kidney Disease
Since the outbreak of coronavirus disease 2019 (COVID-19) in December 2019, the disease has spread rapidly across the globe. Up to April 1, 2020, there have been 823,626 confirmed cases and 40,598 deaths. Actual case fatality ratio is still unknown but some studies have reported ranges between 1.4%—3.8%.
- COVID-19-Associated Collapsing Glomerulopathy: An Emerging Entity
Coronavirus Disease 2019 (COVID-19) is an emerging human infectious disease caused by a novel β coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clinical manifestations range from asymptomatic infection, self-limited flu-like symptoms, to severe acute pneumonia with high mortality.
- Tubuloreticular inclusions in COVID-19-related collapsing glomerulopathy
A 79-year-old male of African ancestry, with a history of hemorrhagic stroke, monoclonal gammopathy of unknown significance and chronic kidney disease stage 3 due to hypertension was admitted to Bichat hospital on day 1 after the first symptom of COVID-19 (fever). SARS-CoV 2 PCR was positive on nasal swab. At admission urinary dipstick was normal and plasma creatinine was 224 μmol/L. On day 4 plasma albumin was at 29 g/L and proteinuria was 11.4 g per gram of urinary creatinine (80% of albumin).
- Assessing and improving the capacity of district health services in the management of Acute Kidney Injury in low and middle-income countries
- COVID-19 and the Renin-Angiotensin System
In late 2019, a coronavirus disease (COVID-19) leading to Severe Acute Respiratory Syndrome (SARS) started in China and has become a pandemic. The responsible virus has been designated SARS-CoV-2. The cellular receptor for SARS-CoV-2 is angiotensin-converting-enzyme 2 (ACE2), a mostly membrane-bound homologue of angiotensin converting enzyme (ACE) that has generated great interest in the interaction between COVID-19 and the renin-angiotensin system (RAS)1, as well as in the medicines commonly used to block the RAS.
- Kidney disease is associated with in-hospital death of patients with COVID-19
Yichun Cheng, Ran Luo, Kun Wang, Meng Zhang, Zhixiang Wang, Lei Dong, Junhua Li, Ying Yao, Shuwang Ge, Gang Xu
- COVID-19 therapeutic options for patients with Kidney Disease
Hassan Izzedine, Kenar D. Jhaveri, Mark A. Perazella
- COVID-19 Guidance for People with Hypertension From the World Hypertension League
Description: In order to provide some guidance to people with hypertension on how to best protect themselves from the novel coronavirus, COVID-19, the World Hypertension Executive has created the attached document, “COVID-19 Guidance for People with Hypertension”, based on studies currently available
- Managing COVID-19 for people with NCDs
The resources below provide the latest information for people living with NCDs and their carers.
- Coronavirus: The Science Explained From UK Research and Innovation
A good general purpose resource
- COVID-19 Open Research Dataset with information on COVID-19 and coronavirus-related research (e.g. SARS, MERS, etc.) from the following sources
- PubMed’s PMC open access corpus on COVID-19
- Additional COVID-19 research articles from a corpus maintained by the WHO
- bioRxiv and medRxiv pre-prints
- NEJM COVID-19 literature
A collection of articles and other resources on the Coronavirus (Covid-19) outbreak, including clinical reports, management guidelines, and commentary.
- JAMA Coronavirus Resource Centre
Browse the JAMA Network COVID-19 collection below, including Q&A’s with NIAID’s Anthony Fauci, an interactive map of the outbreak courtesy of The Johns Hopkins Center for Systems Science and Engineering, and past publications on vaccine development, infection control, and public health preparedness.
- COVID-19 at the Lancet
This resource brings together new 2019 novel coronavirus disease (COVID-19) content from across The Lancet journals as it is published.
- Kidney diseases in the time of COVID-19: major challenges to patient care. In The Journal of Clinical Investigation
In this viewpoint, the author discusses a number of kidney-specific aspects of COVID-19 infection, noting therapeutic and basic research opportunities
- Renal Impairment in COVID-19. A Review. By Raúl Lombardi MD
a short review of 13 papers with data on frequency of AKI, RRT, associated mortality, as well as the value of urine protein for early diagnosis of renal injury in COVID-19 patients.
- Addressing COVID-19 Face Mask Shortages
Information provided by the Stanford Medicine Anesthesia Informatics and Media Lab
- Ethical Framework for Health Care Institutions Responding to Novel Coronavirus SARS-CoV-2 (COVID-19). From The Hastings Center
Guidelines for Institutional Ethics Services Responding to COVID-19
- Ethical dimensions of COVID-19 for front-line staff. From the Royal College of Physicians
The Royal College of Physicians has published ethical guidance for frontline staff dealing with the COVID-19 pandemic, supported by more than a dozen other health organizations.