Patients who survive the first 30 days of COVID-19 experience an excess burden of acute kidney injury (AKI) and chronic kidney disease (CKD) afterwards, even those without preexisting health conditions or not hospitalized for the illness, study data presented during Kidney Week 2021 suggest.
“The absolute rates of AKI and CKD suggest that the burden of kidney disease due to COVID-19 is significant,” lead investigator Ziyad Al-Aly, MD, of the Saint Louis Health Care System Clinical Epidemiology Center in Saint Louis, Missouri, said in an interview. “We estimate upward of 500,000 people experience some form of kidney impairment as a result of COVID in the US alone. I think post-COVID care pathways should involve attention to kidney health and disease. Nephrologists should be prepared to provide care for these patients.”
Dr Al-Aly and colleagues compared 181,384 patients in the US Veterans Health Care System who had COVID-19 and survived the first 30 days of infection with 4,397,509 control patients without COVID-19. They calculated the adjusted excess burdens of AKI and CKD in cases per 1000 persons at 6 months.
After a median follow-up of 150 days, the overall adjusted excess burden of AKI and CKD due to COVID-19 was 6.07 and 7.19 cases per 1000 persons at 6 months, respectively.
The excess burdens of AKI increased with the severity of acute infection: 1.28, 28.11, and 73.18 cases per 1000 persons for COVID-19 patients without hospitalization, hospitalized, and admitted to intensive care units, respectively. The excess burdens of CKD were 1.66, 36.41, and 82.55 cases per 1000 persons, respectively.
Further, the excess burdens of both outcomes increased with age and Charlson Comorbidity Index (CCI). For AKI, the excess burdens were 1.33, 6.36, and 12.32 cases per 1000 persons at 6 months for patients aged 60 years or less, 60-70 years, and older than 70 years, respectively. Patients with CCI of 0, 1-3, and more than 3 had excess burdens of 2.62, 8.87, and 25.07 cases per 1000 persons, respectively. For CKD, the excess burdens were 0.87, 6.53, and 19.24 cases per 1000 persons for patients aged 60 years or less, 60-70 years, and older than 70 years, respectively, and 3.60, 10.57, and 20.17 cases per 1000 persons for those with a CCI of 0, 1-3, more than 3, respectively.
Xie Y, Bowe BC, Gibson AK, Xu E, Al-Aly Z. Burdens of AKI and CKD among COVID-19 survivors. Presented at: Kidney Week 2021, November 2-7, 2021. Abstract PO0019.