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Kidney Week

Abstract: TH-PO905

Is COVID-19 Infection Associated With the Progression of Kidney Disease? Findings From a Population Based Observational Study From British Columbia, Canada

Session Information

  • COVID-19: Long COVID
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Atiquzzaman, Mohammad, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
  • Djurdjev, Ognjenka, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
  • Zheng, Yuyan, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
  • Er, Lee, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
  • Birks, Peter C., The University of British Columbia, Vancouver, British Columbia, Canada
  • Bevilacqua, Micheli U., The University of British Columbia, Vancouver, British Columbia, Canada
  • Oliver, Matthew J., Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • Levin, Adeera, The University of British Columbia, Vancouver, British Columbia, Canada
Background

Recent research suggests that COVID-19 infection is associated with acute kidney injury (AKI). Together the inflammation caused by the virus in the kidneys and the episodes of AKIs are risk factors for progression of kidney diseases. We investigated the risk of progression to kidney failure among chronic kidney disease (CKD) patients from BC, Canada who were infected with COVID-19.

Methods

In this retrospective cohort study, we analyzed a cohort of 22,188 non-dialysis CKD patients aged ≥18 years, with no prior history of ESKD and COVID-19 infection before the cohort entry date between January 27, 2020 & December 15, 2021. The cohort was derived from Patient Records and Outcome Management Information System (PROMIS), a population based integrated registry database for CKD patients under the nephrologist care in BC. Incident COVID-19 cases were iteratively matched without replacement to non-COVID-19 controls (1:3 ratio) based on age, sex, region of residency, diabetes status, eGFR and urine ACR, CKD vintage and COVID-19 vaccination status as of COVID-19 diagnosis date. The primary outcome was a composite of initiation of maintenance dialysis defined by dialysis performed for ≥4 weeks, a sustained decline in eGFR defined by ≥40% decline from baseline that sustained over ≥4 weeks or incident kidney transplantation. Estimated HR and 95% CI using Fine and Gray subdistribution hazard model to account for death as a competing risk.

Results

The analytic data included 1,708 patients, 475 (28%) COVID-19 cases and 1,233 (72%) non-COVID-19 controls. Median age was 71 years, 53% was male. Median follow-up was 8.3 months, 70 (4.10%) patients progressed to kidney failure. Among the non-dialysis CKD patients, the risk of developing kidney failure in COVID-19 infected cases was 24% higher compared to matched, non-COVID-19 infected controls. The HR (95% CI) was 1.24 (0.75, 2.06) (p-value: 0.39).

Conclusion

COVID-19 infection in non-dialysis CKD patients appeared to be associated with higher risk of progression to kidney failure. Although not statistically significant, the substantial increase in risk estimate warrants close monitoring of kidney function among CKD patients after COVID-19 infection.

Funding

  • Government Support – Non-U.S.