Background: The acute and long-term effects of SARS-CoV2 infection in individuals with glomerular diseases (GN) are still unclear. To address this relevant issue, we created the International Registry of COVID-19 infection in glomerulonephritis (IRoc-GN). Methods: We collected serial information on kidney-related and kidney-unrelated outcomes from 125 GN patients (63 hospitalized and 62 outpatients) and 83 non-GN hospitalized patients with COVID-19 and a median follow-up period of 6.4 (IQR: 2.3 to 9.6) months after diagnosis. We used logistic regression for the analyses of clinical outcomes and linear mixed models for the longitudinal analyses of eGFR. All multiple-regression models were adjusted for age, gender, ethnicity, and RAASi use. Results: After adjustment for pre-COVID-19 eGFR and other confounders, mortality and AKI did not differ between GN patients and controls (adjusted odds ratio [aOR] for AKI: 1.28 [95% CI: 0.46 to 3.60]; P=0.64). The main predictor of AKI was pre-COVID-19 eGFR (aOR per 1SD unit decrease in eGFR: 3.04 [95% CI: 1.76 to 5.28]; P<0.001). GN patients developing AKI were less likely to recover pre-COVID-19 eGFR compared to controls (adjusted 6-month post-COVID-19 eGFR = 0.41 [95%CI: 0.25 to 0.56] times pre-COVID-19 eGFR). Shorter duration of GN diagnosis, higher pre-COVID-19 proteinuria, and diagnosis of focal segmental glomerulosclerosis or minimal change disease (FSGS/MCD) were associated with a lower post-COVID-19 eGFR. Conclusions: Pre-COVID-19 eGFR is the main risk factor for AKI regardless from GN diagnosis. However, GN patients are at higher risk of impaired eGFR recovery after COVID-19-associated AKI. These patients (especially those with high baseline proteinuria or FSGS/MCD diagnosis) should be closely monitored not only during the acute phases of COVID-19, but also after its resolution.
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