Decoding COVID-19 and Long-Term Acute Kidney Failure

New research from UC Davis Health has some good news about COVID-19 and kidney health. Even though many people in the hospital with COVID-19 face kidney issues, like acute kidney injury (AKI) and other problems, this study found that the virus is not strongly associated with the long-term loss of kidney health of those affected by COVID-19. So, it seems like COVID-19 might not have a big impact on long-term kidney health.

“Early in the COVID-19 pandemic, kidney abnormalities were often recognized in patients with COVID-19,” said Hiba A.M. Hamdan, the principal investigator of the study and health sciences assistant clinical professor in the Division of Nephrology. “Given how infectious COVID-19 was and the large numbers of individuals being hospitalized with the virus, it was imperative we better understand the short and longer-term kidney sequelae of COVID-19 infection so we could prepare if we saw a significant uptick in the incidence of chronic kidney disease.”

In the pandemic’s initial year, research revealed that more than 25% of COVID-19 hospital patients faced AKI, a sudden kidney issue. Acute kidney failure, or acute renal failure, is swift kidney damage occurring within hours or days. Some reports noted continued long-term kidney function issues post-COVID-19 despite relatively short follow-up periods.

“Given how infectious COVID-19 was and the large numbers of individuals being hospitalized with the virus, it was imperative we better understand the short and longer-term kidney sequelae of COVID-19 infection so we could prepare if we saw a significant uptick in the incidence of chronic kidney disease at all stages.”Hiba A.M. Hamdan

In investigating potential long-term kidney issues in hospitalized COVID-19 patients, researchers analyzed electronic health records from adults in the University of California (UC) Health System, encompassing six medical centers. They looked at:

• Individuals who underwent PCR testing and tested positive for SARS-CoV-2 between March 1, 2020, and Dec. 31, 2021.
• Patients hospitalized within 10 days of testing.
• Patients hospitalized for at least one day.
• Individuals not diagnosed with end-stage renal disease.
• Non-pregnant patients.

The AKI inpatient cohort comprised 5,451 COVID-19 individuals, averaging 59 years in age, with 59% being male and 45% Hispanic. The rate of COVID-19 patients experiencing AKI fluctuated between 20-38% throughout the reviewed period.

Researchers assessed long-term kidney function in the cohort by examining estimated glomerular filtration rate (eGFR) trajectories. This involved individuals with COVID-19 and a distinct group with AKI (acute kidney failure) but without COVID-19. The study followed patients until Dec. 31, 2022, and found no significant difference in eGFR loss between the two groups during the roughly two-year follow-up period.

Likewise, a sizable cohort studying the enduring impacts of COVID-19 on kidney function found comparable results. This pertained to patients who did not experience a hospitalization event within 10 days after the initial SARS-CoV-2 PCR testing.

“This study has important implications because we examined a very diverse cohort from one of the largest healthcare systems in California and had one of the longest reported follow-up periods of kidney function following COVID-19 infection,” explained Hamdan. “Our hope is that these findings help guide our healthcare system and others in planning for post-COVID-19 care.” This also has implications for other respiratory viruses and how they can impact kidney function.

Source: UCDavis Health