Mortality Rates and Predictors in Hospitalized COVID-19 Patients Receiving Hemodialysis for Different Conditions

Background: To determine the mortality rates and predictors in patients hospitalized and treated for COVID-19 infection, who are also receiving hemodialysis (HD). Method: This retrospective study included 104 patients who received HD and were hospitalized due to COVID-19 between March 2020 and 2021. Hospitalized patients who received HD were categorized into three groups: maintenance HD (MHD) patients, those receiving HD due to acute kidney injury (AKI) or chronic kidney disease (CKD), and those receiving HD due to AKI without CKD. Results: Sixty-four (62%) of the patients were male. The mean age of the patients was 68±13 years. 37 were receiving MHD, 41 were receiving HD due to AKI on CKD, and 26 received HD due to AKI without CKD. 12(32%) of MHD patients and 29(71%) of patients receiving HD due to AKI on CKD died (p=0.002). Of the patients receiving HD due to AKI without CKD, 26(100%) died. Patients receiving HD due to AKI without CKD had the highest mortality rate compared to both MHD and AKI in CKD groups (p<0.001). Factors predicting mortality included lymphopenia, HD due to AKI on CKD, a more than two-fold increase in AST, the requirement of mechanical ventilation, and elevated d-dimer levels. Conclusions: We showed high mortality in all patients receiving HD for different clinical conditions. These findings highlight the necessity of close monitoring and early intervention in COVID-19 patients who received HD.