Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy

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dc.authorscopusid47661749700
dc.authorscopusid22979074100
dc.authorscopusid36817473200
dc.authorscopusid7006186181
dc.authorscopusid7005791838
dc.authorscopusid57194755490
dc.authorscopusid57190388857
dc.contributor.authorVart P.
dc.contributor.authorDuivenvoorden R.
dc.contributor.authorAdema A.
dc.contributor.authorCovic A.
dc.contributor.authorFinne P.
dc.contributor.authorBraak N.H.-T.
dc.contributor.authorLaine K.
dc.date.accessioned2024-08-04T20:03:30Z
dc.date.available2024-08-04T20:03:30Z
dc.date.issued2022
dc.departmentİnönü Üniversitesien_US
dc.description.abstractIn the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we examined whether the male sex is still a risk factor for mortality among patients on KFRT with COVID-19. From the European Renal Association COVID-19 Database (ERACODA), we examined patients on KFRT with COVID-19 who presented between February 1st, 2020, and April 30th, 2021. 1204 kidney transplant recipients (male 62.0%, mean age 56.4 years) and 3206 dialysis patients (male 61.8%, mean age 67.7 years) were examined. Three-month mortality in kidney transplant recipients was 16.9% in males and 18.6% in females (p = 0.31) and in dialysis patients 27.1% in males and 21.9% in females (p = 0.001). The adjusted HR for the risk of 3-month mortality in males (vs females) was 0.89 (95% CI 65, 1.23, p = 0.49) in kidney transplant recipients and 1.33 (95% CI 1.13, 1.56, p = 0.001) in dialysis patients (pinteraction = 0.02). In a fully adjusted model, the aHR for the risk of 3-month mortality in kidney transplant recipients (vs. dialysis patients) was 1.39 (95% CI 1.02, 1.89, p = 0.04) in males and 2.04 (95% CI 1.40, 2.97, p < 0.001) in females (pinteraction = 0.02). In patients on KFRT with COVID-19, the male sex is not a risk factor for mortality among kidney transplant recipients but remains a risk factor among dialysis patients. The use of immunosuppressants in kidney transplant recipients, among other factors, may have narrowed the difference in the immune response to COVID-19 between men and women, and therefore reduced the sex difference in COVID-19 mortality risk. © 2022, The Author(s).en_US
dc.description.sponsorshipBaxter International; Nierstichtingen_US
dc.description.sponsorshipUnrestricted research grants were obtained from the European Renal Association, The Dutch Kidney Foundation, Baxter, and Sandoz. Neither organization had any role in the design of the study, interpretation of results, nor in writing of the article.en_US
dc.description.sponsorshipThe ERACODA collaboration is an initiative to study prognosis and risk factors for mortality due to COVID-19 in patients with a kidney transplant or on dialysis that is endorsed by the ERA-EDTA. ERACODA is an acronym for European Renal Association COVID-19 Database. The organizational structure contains a Working Group assisted by a Management Team and an Advisory Board. The ERACODA Working Group members: Franssen CFM, Gansevoort RT (coordinator), Hemmelder MH, Hilbrands LB and Jager KJ. The ERACODA Management Team members: Duivenvoorden R, Noordzij M and Vart P. The ERACODA Advisory Board members: Abramowicz D, Basile C, Covic A, Crespo M, Massy ZA, Mitra S, Petridou E, Sanchez JE, White C. We thank all people that entered information in the ERACODA database for their participation, and especially all healthcare workers that have taken care of the included COVID-19 patients. The abstract of this manuscript was presented at the European Renal Association Conference 2022 and has been published in the Nephrology, Dialysis, and Transplantation journal (https://doi.org/10.1093/ndt/gfac095.003). The manuscript has not been submitted for consideration elsewhere.en_US
dc.identifier.doi10.1038/s41598-022-22657-4
dc.identifier.issn2045-2322
dc.identifier.issue1en_US
dc.identifier.pmid36289317en_US
dc.identifier.scopus2-s2.0-85140708372en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1038/s41598-022-22657-4
dc.identifier.urihttps://hdl.handle.net/11616/91873
dc.identifier.volume12en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherNature Researchen_US
dc.relation.ispartofScientific Reportsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectimmunosuppressive agenten_US
dc.subjectadverse eventen_US
dc.subjectageden_US
dc.subjectfemaleen_US
dc.subjecthemodialysisen_US
dc.subjecthumanen_US
dc.subjectkidneyen_US
dc.subjectkidney transplantationen_US
dc.subjectmaleen_US
dc.subjectmiddle ageden_US
dc.subjectrisk factoren_US
dc.subjectsexual characteristicsen_US
dc.subjectAgeden_US
dc.subjectCOVID-19en_US
dc.subjectFemaleen_US
dc.subjectHumansen_US
dc.subjectImmunosuppressive Agentsen_US
dc.subjectKidneyen_US
dc.subjectKidney Transplantationen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectRenal Dialysisen_US
dc.subjectRisk Factorsen_US
dc.subjectSex Characteristicsen_US
dc.titleSex differences in COVID-19 mortality risk in patients on kidney function replacement therapyen_US
dc.typeArticleen_US

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