COVID-19 and Kidney Disease: Progress in Health Inequity From Low-Income Settings

Tannor, Elliot Koranteng; Bajpal, Divya; Nlandu, Yannick Mayamba; Wijewickrama, Eranga

doi:10.1016/j.semnephrol.2023.151318

Cited by 10 publications

(6 citation statements)

References 123 publications

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“…The study findings mirrored those reported by Tannor et al [23], emphasizing the exacerbated risks and outcomes of COVID-19 on individuals with pre-existing kidney conditions, particularly underlining the severe consequences in low-income settings due to inadequate healthcare infrastructure. Both studies underscored the heightened incidence of acute kidney injury and the progression to chronic kidney disease post-COVID-19 infection, pointing out the global inequities in managing these complications.…”

Section: Literature Findingssupporting

confidence: 84%

Kidney Function Tests and Continuous eGFR Decrease at Six Months after SARS-CoV-2 Infection in Patients Clinically Diagnosed with Post-COVID Syndrome

Boruga,

Septimiu-Radu,

Nandarge

et al. 2024

Biomedicines

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The long-term sequelae of SARS-CoV-2 infection are still under research, since extensive studies showed plenty of systemic effects of the viral infection, extending even after the acute phase of the infection. This study evaluated kidney function tests six months after SARS-CoV-2 infection in patients clinically diagnosed with Post-COVID Syndrome, hypothesizing persistent renal dysfunction evidenced by altered kidney function tests compared to baseline levels. Continuous eGFR decrease <30 at six months post-infection was considered the main study outcome. Conducted at the “Victor Babes” Hospital, this retrospective observational study involved adults with laboratory-confirmed SARS-CoV-2 infection and clinically-diagnosed Post-COVID Syndrome, excluding those with prior chronic kidney disease or significant renal impairment. Kidney function tests, including serum creatinine, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), alongside markers of kidney damage such as proteinuria and hematuria, were analyzed. Among 206 participants, significant differences were observed between the control (n = 114) and the Post-COVID group (n = 92). The Post-COVID group exhibited higher serum creatinine (109.7 μmol/L vs. 84.5 μmol/L, p < 0.001), lower eGFR (65.3mL/min/1.73 m2 vs. 91.2 mL/min/1.73 m2, p < 0.001), and elevated BUN levels (23.7 mg/dL vs. 15.2 mg/dL, p < 0.001) compared to the control group. Regression analysis highlighted significant predictors of continuous eGFR decrease <30 at six months post-infection. The development of acute kidney injury (AKI) during the initial COVID-19 illness emerged as a strong predictor of reduced eGFR (β = 3.47, p < 0.001). Additional factors, including a creatinine increase (23 μmol/L above the normal range) and an elevated Albumin to Creatinine Ratio (ACR) (>11 mg/g above the normal range), were significantly associated with eGFR reduction. Patients with Post-COVID Syndrome demonstrate significant renal impairment six months post-SARS-CoV-2 infection. The study’s findings stress the need for ongoing monitoring and intervention strategies for renal health in affected individuals, underscoring the persistent impact of COVID-19 on renal function.

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Section: Literature Findingssupporting

confidence: 84%

Kidney Function Tests and Continuous eGFR Decrease at Six Months after SARS-CoV-2 Infection in Patients Clinically Diagnosed with Post-COVID Syndrome

Boruga,

Septimiu-Radu,

Nandarge

et al. 2024

Biomedicines

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“…By day 15, five KTRs had died, highlighting of the risk of disease progression and death in this population. In another study of hospitalized COVID-19 patients on dialysis, 31% had died within a median of six days postadmission while 75% needed mechanical ventilation [20]. Altogether, these findings underscore the need to prevent the spread of SARS-CoV-2 in this high-risk group.…”

Section: Covid-19 Mortality In Eskd Dialysis and Kidney Transplantationmentioning

confidence: 90%

Mitigating Endemic COVID-19 Risks in Patients with Chronic Kidney Disease and Kidney Transplantation: A Narrative Review

Khan,

Noppakun,

Bruminhent

et al. 2024

Preprint

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Patients with chronic kidney disease (CKD), particularly those with end-stage kidney disease (ESKD) undergoing dialysis or kidney transplantation, face ongoing challenges in relation to the risk of COVID-19. In addition to their underlying condition, factors such as immune-evasive variants, immunosuppressive therapies, and the need for dialysis contribute to poor COVID-19 outcomes in this population. Severe COVID-19 can lead to the deterioration of CKD/ESKD, resulting in acute kidney injury, septic shock, and respiratory failure. Moreover, patients with CKD/ESKD have shown impaired response to COVID-19 vaccination, with seroconversion failures associated with the burden of immunosuppressive treatments, further heightening their vulnerability to severe disease. Despite the current endemic, it is crucial to acknowledge the ongoing significance of COVID-19 as a serious threat to patients burdened with chronic diseases like CKD and ESRD. Understanding the impact of COVID-19 on these patients is essential, as they remain at risk of severe disease progression. This paper presents the results of a literature review to enhance our understanding of COVID-19-related risks in patients with CKD/ESKD. Expert insights and illustrative scenarios provide practical perspectives and highlight the importance of risk stratification based on clinical factors for guiding targeted measures and treatments to mitigate COVID-19 risks in these vulnerable patients.

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“…AKI in some COVID–19–confirmed patients may prompt the need for renal replacement therapy (RRT) or even a kidney transplant. The impact of these outcomes is more apparent in resource-limited settings, such as in the Philippine healthcare system [15]. AKI in COVID-19 encumbers the healthcare system by directly affecting the efficient utilization of hemodialysis machines, staff, and other hospital resources.…”

Section: Introductionmentioning

confidence: 99%

“…AKI in COVID-19 encumbers the healthcare system by directly affecting the efficient utilization of hemodialysis machines, staff, and other hospital resources. Also, long-term monitoring is needed to avoid the progression of AKI to chronic kidney disease (CKD) and reduce the associated mortality in high-risk populations [15]. As such, it is important to recognize means to promptly identify and prevent further renal injury and facilitate recovery of renal function in patients with and who are recovering from COVID-19 [16].…”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury outcomes of COVID-19 confirmed patients in a Philippine tertiary hospital: A retrospective study

Sayson,

Kalaw,

Ordona

et al. 2024

Preprint

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The novel coronavirus (COVID-19) is known to be the fifth pandemic causing massive deaths worldwide. This virus has not only been deeply associated with acute respiratory distress, but also acute kidney injury (AKI). This study describes the baseline characteristics and various outcomes of AKI based on the KDIGO 2012 Clinical Practice Guidelines in patients hospitalized with COVID-19 at a Philippine tertiary hospital. A total of 195 patient records were retrospectively reviewed for the study. Of the 195 patients, 81(42%) patients developed AKI. Significant baseline characteristics included older age (56.28 + 14.12), presence of hypertension (p=0.004), diabetes mellitus (p=0.002), and cardiovascular disease (p=0.003). Also, the use of diuretics, inotropes and antibiotics were more prevalent in patients who developed AKI. Most of the patients who had AKI were categorized as stage 1 (49.38%). Mechanical ventilation was significantly (p<0.001) more prevalent in patients with AKI (20.99%) compared to patients without AKI (5.26%). There was significantly higher rates (p<0.001) of renal replacement therapy in patients with AKI (30.86%). Lastly, higher mortality rates were observed in patients with AKI (50.62%) versus patients without AKI (12.28%). Our study demonstrated that patients with COVID-19 can develop AKI and tend to have a poorer prognosis.

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COVID-19 and Kidney Disease: Progress in Health Inequity From Low-Income Settings

Cited by 10 publications

References 123 publications

Kidney Function Tests and Continuous eGFR Decrease at Six Months after SARS-CoV-2 Infection in Patients Clinically Diagnosed with Post-COVID Syndrome

Kidney Function Tests and Continuous eGFR Decrease at Six Months after SARS-CoV-2 Infection in Patients Clinically Diagnosed with Post-COVID Syndrome

Mitigating Endemic COVID-19 Risks in Patients with Chronic Kidney Disease and Kidney Transplantation: A Narrative Review

Acute kidney injury outcomes of COVID-19 confirmed patients in a Philippine tertiary hospital: A retrospective study

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