3 research outputs found
The impact of COVID-19 infection before the vaccination era on the hospitalized patients requiring hemodialysis: a single-center retrospective cohort
Due to effective vaccinations, the COVID-19 (coronavirus disease 2019) infection that caused the pandemic has a milder clinical course. We aimed to assess the mortality of hospitalized COVID-19 patients before the vaccination era. We investigated the mortality in those patients between 1 October 2020 and 31 May 2021 who received hemodialysis treatment [patients with previously normal renal function (nCKD), patients with chronic kidney disease previously not requiring hemodialysis (CKDnonHD), chronic kidney disease (CKD), and patients on regular hemodialysis (pHD)]. In addition, participants were followed up for all-cause mortality in the National Health Service database until 1 December 2021. In our center, 83 of 108 (76.9%) were included in the analysis due to missing covariates. Over a median of 26 (interquartile range 11-266) days of follow-up, 20 of 22 (90.9%) of nCKD, 23 of 24 (95.8%) of CKDnonHD, and 17 of 37 (45.9%) pHD patients died (p < 0.001). In general, patients with nCKD had fewer comorbidities but more severe presentations. In contrast, the patients with pHD had the least severe symptoms (p < 0.001). In a model adjusted for independent predictors of all-cause mortality (C-reactive protein and serum albumin), CKDnonHD patients had increased mortality [hazard ratio (HR) 1.91, 95% confidence interval (CI), 1.02-3.60], while pHD patients had decreased mortality (HR 0.41, 95% CI 0.20-0.81) compared to nCKD patients. After further adjustment for the need for intensive care, the difference in mortality between the nCKD and pHD groups became non-significant. Despite the limitations of our study, it seems that the survival of previously hemodialysis patients was significantly better
NETosis: an emerging therapeutic target in renal diseases
Introduction: Neutrophil extracellular traps (NETs) are web-like structures
composed of nuclear and granular components. The primary role of NETS is
to prevent the dissemination of microbes and facilitate their elimination.
However, this process is accompanied by collateral proinflammatory adverse
effects when the NET release becomes uncontrollable, or clearance is impaired.
Although NET-induced organ damage is conducted primarily and indirectly via
immune complexes and the subsequent release of cytokines, their direct effects
on cells are also remarkable. NETosis plays a critical pathogenic role in several
renal disorders, such as the early phase of acute tubular necrosis, anti-neutrophil
cytoplasmic antibody-mediated renal vasculitis, lupus nephritis, thrombotic
microangiopathies, anti-glomerular basement membrane disease, and diabetic
nephropathy. Their substantial contribution in the course of these disorders
makes them a desirable target in the therapeutic armamentarium. This article
gives an in-depth review of the heterogeneous pathogenesis and physiological
regulations of NETosis and its pivotal role in renal diseases. Based on the
pathogenesis, the article also outlines the current therapeutic options and
possible molecular targets in the treatment of NET-related renal disorders.
Methods: We carried out thorough literature research published in PubMed and
Google Scholar, including a comprehensive review and analysis of the
classification, pathomechanisms, and a broad spectrum of NET-related kidney
disorders.
Conclusions: NETosis plays a pivotal role in certain renal diseases. It initiates and
maintains inflammatory and autoimmune disorders, thus making it a desirable
target for improving patient and renal outcomes. Better understanding and
clinical translation of the pathogenesis are crucial aspects to treatment, for
improving patient, and renal outcomes
The impact of COVID-19 infection before the vaccination era on the hospitalized patients requiring hemodialysis: a single-center retrospective cohort
AbstractDue to effective vaccinations, the COVID-19 (coronavirus disease 2019) infection that caused the pandemic has a milder clinical course. We aimed to assess the mortality of hospitalized COVID-19 patients before the vaccination era. We investigated the mortality in those patients between 1 October 2020 and 31 May 2021 who received hemodialysis treatment [patients with previously normal renal function (nCKD), patients with chronic kidney disease previously not requiring hemodialysis (CKDnonHD), chronic kidney disease (CKD), and patients on regular hemodialysis (pHD)]. In addition, participants were followed up for all-cause mortality in the National Health Service database until 1 December 2021. In our center, 83 of 108 (76.9%) were included in the analysis due to missing covariates. Over a median of 26 (interquartile range 11–266) days of follow-up, 20 of 22 (90.9%) of nCKD, 23 of 24 (95.8%) of CKDnonHD, and 17 of 37 (45.9%) pHD patients died (p < 0.001). In general, patients with nCKD had fewer comorbidities but more severe presentations. In contrast, the patients with pHD had the least severe symptoms (p < 0.001). In a model adjusted for independent predictors of all-cause mortality (C-reactive protein and serum albumin), CKDnonHD patients had increased mortality [hazard ratio (HR) 1.91, 95% confidence interval (CI), 1.02–3.60], while pHD patients had decreased mortality (HR 0.41, 95% CI 0.20–0.81) compared to nCKD patients. After further adjustment for the need for intensive care, the difference in mortality between the nCKD and pHD groups became non-significant. Despite the limitations of our study, it seems that the survival of previously hemodialysis patients was significantly better