The impact of SARS-CoV-2 infection on renal function in patients with biopsy-proven kidney diseases.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 15 08 2023
accepted: 06 12 2023
medline: 22 12 2023
pubmed: 22 12 2023
entrez: 22 12 2023
Statut: epublish

Résumé

We sought to evaluate the long-term effects of COVID-19 on renal function in patients with biopsy-proven kidney diseases. A total of 451 patients with biopsy-proven kidney disease and at least 12 months of follow-up subsequent to COVID-19 pandemic onset were included in the study. The primary study endpoint was a composite of a persistent decline of more than 30% in eGFR or ESRD. 23.1% of patients had COVID-19 during a follow-up period of 2.5 y (0.8-2.6), while 17.6% of patients reached the composite endpoint. Those with COVID-19 were more likely to reach the composite endpoint [26.7% vs. 14.8%; OR, 2.1 (95%CI, 1.23-3.58), p = 0.006). There was a significant eGFR change in the first year of follow-up between the two study groups [-2.24 (95%CI,-4.86; 0.37) vs. +2.31 (95%CI, 0.78; 3.85) ml/min, p = 0.004], with an adjusted mean difference of -4.68 ml/min (95%CI,-7.7; -1.59)(p = 0.03). The trend for worse renal outcomes remained consistent in patients with IgAN, MN and FSGS, but not in those with LN. After multivariate adjustment, the independent predictors of the composite endpoint were baseline eGFR (HR, 0.94; 95%CI, 0.92-0.95), COVID-19 (HR, 1.91; 1.16-3.12) and male gender (HR, 1.64; 95%CI, 1.01-2.66). In multivariate linear regression analysis, COVID-19 independently determined a reduction of eGFR at 12 months by 4.62 ml/min/1.73m2 (β coefficient, -4.62; 95%CI, -7.74 to -1.5, p = 0.004). There is a significant impact of COVID-19 on long-term renal function in patients with biopsy-proven kidney diseases, leading to a greater decline of eGFR and a worse renal survival.

Sections du résumé

BACKGROUND BACKGROUND
We sought to evaluate the long-term effects of COVID-19 on renal function in patients with biopsy-proven kidney diseases.
METHODS METHODS
A total of 451 patients with biopsy-proven kidney disease and at least 12 months of follow-up subsequent to COVID-19 pandemic onset were included in the study. The primary study endpoint was a composite of a persistent decline of more than 30% in eGFR or ESRD.
RESULTS RESULTS
23.1% of patients had COVID-19 during a follow-up period of 2.5 y (0.8-2.6), while 17.6% of patients reached the composite endpoint. Those with COVID-19 were more likely to reach the composite endpoint [26.7% vs. 14.8%; OR, 2.1 (95%CI, 1.23-3.58), p = 0.006). There was a significant eGFR change in the first year of follow-up between the two study groups [-2.24 (95%CI,-4.86; 0.37) vs. +2.31 (95%CI, 0.78; 3.85) ml/min, p = 0.004], with an adjusted mean difference of -4.68 ml/min (95%CI,-7.7; -1.59)(p = 0.03). The trend for worse renal outcomes remained consistent in patients with IgAN, MN and FSGS, but not in those with LN. After multivariate adjustment, the independent predictors of the composite endpoint were baseline eGFR (HR, 0.94; 95%CI, 0.92-0.95), COVID-19 (HR, 1.91; 1.16-3.12) and male gender (HR, 1.64; 95%CI, 1.01-2.66). In multivariate linear regression analysis, COVID-19 independently determined a reduction of eGFR at 12 months by 4.62 ml/min/1.73m2 (β coefficient, -4.62; 95%CI, -7.74 to -1.5, p = 0.004).
CONCLUSIONS CONCLUSIONS
There is a significant impact of COVID-19 on long-term renal function in patients with biopsy-proven kidney diseases, leading to a greater decline of eGFR and a worse renal survival.

Identifiants

pubmed: 38134019
doi: 10.1371/journal.pone.0296168
pii: PONE-D-23-25206
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0296168

Informations de copyright

Copyright: © 2023 Obrișcă et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Bogdan Obrișcă (B)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Valentin Mocanu (V)

Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Alexandra Vornicu (A)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Roxana Jurubiță (R)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Bogdan Sorohan (B)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

George Dimofte (G)

Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Camelia Achim (C)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Andreea Andronesi (A)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Georgia Micu (G)

Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Raluca Bobeică (R)

Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Nicu Caceaune (N)

Department of Internal Medicine, Fundeni Clinical Institute, Bucharest, Romania.

Alexandru Procop (A)

Department of Pathology, Fundeni Clinical Institute, Bucharest, Romania.

Vlad Herlea (V)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Pathology, Fundeni Clinical Institute, Bucharest, Romania.

Mihaela Gherghiceanu (M)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
5"Victor Babes" National Institute of Pathology, Bucharest, Romania.

Gener Ismail (G)

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania.

Classifications MeSH