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Kidney Week

Abstract: TH-PO1103

Risk Factors for the Relapse and Aggravation of Patients with Primary Membranous Nephropathy After COVID-19 Infection

Session Information

  • COVID-19 - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Shu, Yue, Peking University First Hospital Department of Nephrology, Beijing, Beijing, China
  • Cui, Zhao, Peking University First Hospital Department of Nephrology, Beijing, Beijing, China
Background

Relapse cases of membranous nephropathy (MN) and other glomerular diseases have been reported after the infection of COVID-19. The risk factors for MN disease progression after COVID-19 infection need to be clarified.

Methods

A retrospective study were conducted from November 11th, 2022 to February 22nd, 2023 on 656 consecutive patients with biopsy-proven primary MN who had been treated and followed up for more than 6 months. Logistic regression analyses were performed to identify the risk factors.

Results

555 (84.6%) patients underwent COVID-19 infection. Among them, 112 (20.2%) patients experienced urinary protein aggravation > 50% from the baseline, including 30 (5.4%) patients with relapse of nephrotic syndrome. 16 (2.9%) patients got immune aggravation with the increase of anti-PLA2R levels and five (0.9%) patients got immune relapse with antibody reoccurrence. Ten (1.8%) patients got kidney dysfunction with eGFR reduction > 30% from the baseline, among them two (0.4%) patients progressed into ESKD. Four (0.7%) patients died of respiratory failure. Taken together, 132 (24%) patients experienced disease progression after COVID-19 infection. Multivariate logistic analysis showed that the longer duration of fever (OR 1.118, 95% CI 1.029-1.356, P=0.018), the withdrawal of immunosuppressants and/or steroids (OR 2.571, 95% CI 1.377-4.799, P=0.003) and the longer time of withdrawal (OR 1.113, 95% CI 1.045-1.186, P=0.001) were independent risk factors for MN progression.

Conclusion

The findings proposed an active anti-virus treatment and no or shorter time of immunosuppressants withdrawal for a better prognosis of kidneys on the clinical practice of MN patients with COVID-19 infection.