EFFECT OF HEMODIALYSIS ON OUTCOME OF COVID 19 PATIENTS WITH RENAL FAILURE

Background & Objectives: COVID19 has the capacity to injure organs such as the heart, nervous system, or the kidney besides causing interstitial and alveolar pneumonia1,2. Acute Kidney Injury (AKI) is an independent risk factor for mortality in Covid 19 and is the most frequent extra-pulmonary organ dysfunction associated with ARDS. CKD patients have worsened Covid 19 outcomes due to increased risk of infection-related mortality as a consequence of impaired immunity. However, data comparing AKI and CKD patients on Maintenance Haemodialysis (MHD) in Covid-19 are sparse. So we undertook this study. The purpose of this present work was to evaluate the Effect of Haemodialysis on Outcome of Covid 19 Patients with Renal Failure in a tertiary care hospital in rural settings during the 1st and 2nd wave of Covid – 19 pandemic. Methodology: 342 eligible Covid 19 patients were selected from case les of patients admitted during rst and second wave of Covid 19 at our institute from July 2020 to June 2021. These patients were divided into two groups viz. patients with renal failure (n=171) and without renal failure (n=171). Those with RF were further subdivided into CKD & AKI (n=49 & n=122 respectively). Outcomes were compared in both the groups and intragroup analysis was also done. Results: We found that, in patients with Renal Failure, CKD patients on Maintenance Hemodialysis fared better than AKI patients who did not require Dialysis(mortality - 24.5% vs 35.2% respectively). Also mortality was slightly lower in CKD patients on MHD i.e.24.5% as compared to non-RF patients i.e. 25.1%. Similarly, mortality was higher among patients with AKI who did not need HD i.e. 35.2% when compared to non-RF patients 25.1%. Conclusion: Thus, Acute Kidney Injury (AKI) patients were at risk for more severe disease and worst outcomes, when compared to Chronic Kidney Disease (CKD) patients on MHD. Also CKD patients on Maintenance Hemodialysis (MHD) faired equally or better when compared to non-RF patients. Therefore Haemodialysis could have played a protective role and needs to be explored as a novel treatment modality for SAR-COV-2 infection.