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Kidney Week

Abstract: TH-PO1078

Population Level Effects of COVID-19 Disease (C19D) and Vaccination (C19V) on eGFR

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Argyropoulos, Christos, University of New Mexico Clinical and Translational Science Center, Albuquerque, New Mexico, United States
  • Roumelioti, Maria-Eleni, The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
  • Mir, Hamza, The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
  • Unruh, Mark L., The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
  • Garcia, Pablo, The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
  • Schmidt, Darren W., University of New Mexico Clinical and Translational Science Center, Albuquerque, New Mexico, United States
  • Ahmadzadeh, Amir Ali, Ralph H. Johnson VA, Charleston, South Carolina, United States
Background

C19D increases the prevalence of risk factors for CKD e.g. AKI, diabetes and cardiovascular disease. We sought to characterize the population level impact of repeated C19D vs C19V on eGFR.

Methods

We included everyone who had a C19 test between 3/1/20-3/31/24 in any US institute in the TrinetX database and a baseline serum creatinine (SCr) before 3/1/20. Outpatient clinic or lab SCr values were used to calculate eGFR with the CKD-Epi 2021 formula. To reduce misclassification, individuals with any eGFR < 15 or > 150 and those with fewer than 2 values were excluded. We analyzed the impact of repeated C19D, C19V on eGFR slope with linear mixed models.

Results

We included 1,583,197 pts (figure) whose age was 57.8 ±16 y/o, baseline eGFR 87.8 ± 22; 59% of pts were female; number of Scr, C19D, C19V, follow up time per pt were 6.6 ± 7.8, 0.3 ± 0.7, 0.7 ± 1.3 , 954 ± 369 days respectively. Only 3.5% of all Scr met KDIGO criteria for AKI and there were no deaths. Annual loss of eGFR before any C19D or C19V was ~1.4 ml/min/1.73m2/year. While there was no major effect of C19V on eGFR loss, C19D induced hyperfiltration (up to 2 infections) with a trend for an accelerated small loss of eGFR afterwards (table).

Conclusion

C19D but not C19V induces hyperfiltration after repeated infections, which could represent a lab manifestation of Long Covid. Whether this will translate to higher rates of CKD over time remains unknown.

Effects of repeated C19D and C19V on eGFR slope
CoefficientValue and 95% CI
eGFR slope (uinfected/unvaccinated)-1.36 (-1.37--1.35)
eGFR slope X 1 vaccine0.05 (0.03-0.08)
eGFR slope X 2 vaccines (*)-0.03 (-0.05 - -0.01)
eGFR slope X ≥ 3 vaccines0.09 (0.07-0.11)
eGFR slope X 1 infection0.26 (0.24-0.27)
eGFR slope X 2 infections0.23 (0.20-0.26)
eGFR slope X ≥ 3 infections (+)-0.05 (-0.11-0.00)

All p-values < 0.001 except * (0.007) and + (0.06)

Funding

  • Other NIH Support – DCI, Inc

Digital Object Identifier (DOI)