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      COVID-19 in Hospitalized Patients on Chronic Peritoneal Dialysis: A Case Series

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          Abstract

          Background

          The COVID-19 pandemic has affected the end-stage kidney disease (ESKD) population, with high mortality rates reported among patients on hemodialysis. However, the degree to which it has affected the peritoneal dialysis (PD) population in the United States has not yet been elucidated. In this report, we describe the clinical characteristics, presentations, clinical course, and outcomes of ESKD patients on PD hospitalized with COVID-19.

          Methods

          We describe the characteristics, presentation, and outcomes of adult ESKD patients on chronic PD hospitalized with CO­VID-19 in our 13 major hospitals in the NY health system using descriptive statistical analysis.

          Results

          Of 419 hospitalized patients with ESKD, 11 were on chronic PD therapy (2.6%). Among those 11, 3 patients required mechanical ventilation, 2 of whom died. Of the entire cohort, 9 of the 11 patients (82%) were discharged alive. While fever was a common presentation, more than half of our patients also presented with diarrhea. Interestingly, 3 patients were diagnosed with culture-negative peritonitis during their hospitalization. Seven patients reported positive SARS-CoV-2 exposure from a member of their household.

          Conclusion

          Hospitalized patients on PD with COVID-19 had a relatively mild course, and majority of them were discharged home.

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          Most cited references 3

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          Aspects of immune dysfunction in end-stage renal disease.

          End-stage renal disease (ESRD) is associated with significantly increased morbidity and mortality resulting from cardiovascular disease (CVD) and infections, accounting for 50% and 20%, respectively, of the total mortality in ESRD patients. It is possible that these two complications are linked to alterations in the immune system in ESRD, as uremia is associated with a state of immune dysfunction characterized by immunodepression that contributes to the high prevalence of infections among these patients, as well as by immunoactivation resulting in inflammation that may contribute to CVD. This review describes disorders of the innate and adaptive immune systems in ESRD, underlining the specific role of ESRD-associated disturbances of Toll-like receptors. Finally, based on the emerging links between the alterations of immune system, CVD, and infections in ESRD patients, it emphasizes the potential role of the immune dysfunction in ESRD as an underlying cause for the high mortality in this patient population and the need for more studies in this area.
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            Chronic Hemodialysis Patients Hospitalized with COVID-19 - Short-term Outcomes in Bronx, New York

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              SARS-CoV-2 in the peritoneal waste in a patient treated with peritoneal dialysis

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                Author and article information

                Journal
                Am J Nephrol
                Am. J. Nephrol
                AJN
                American Journal of Nephrology
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                0250-8095
                1421-9670
                August 2020
                30 July 2020
                : 51
                : 8
                : 669-673
                Affiliations
                aDivision of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
                bInstitute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, New York, USA
                cDepartment of Information Services, Northwell Health, New Hyde Park, New York, USA
                Author notes
                *Mala Sachdeva, Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, 100 Community Drive, Great Neck 11021 (USA), msachdeva@ 123456northwell.edu
                Article
                ajn-0051-0669
                10.1159/000510259
                7490491
                32731215
                Copyright © 2020 by S. Karger AG, Basel

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                Page count
                Tables: 3, References: 9, Pages: 5
                Categories
                Novel Research Findings

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