Abstract: TH-PO0909
COVID-19 Disease (C19D) and Vaccination (C19V) Effect on eGFR Slope Among Kidney Transplant Recipients (KTR)
Session Information
- Transplantation: Clinical - Glomerular Diseases, Infections, and Rejection
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Ahmadzadeh, Amir Ali, Ralph H. Johnson VA, Charleston, South Carolina, United States
- Argyropoulos, Christos, University of New Mexico Clinical and Translational Science Center, Albuquerque, New Mexico, United States
- Singh, Pooja P., The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- Singh, Namita, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- Garcia, Pablo, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- Mir, Hamza, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- Unruh, Mark L., The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
Background
While case reports have linked C19D & C19V with glomerulonephritides and AKI among the general population and KTR, little is known about the population effects of C19D and C19V on loss of eGFR over time in KTR.
Methods
We included all patients who had a C19 test between 3/1/20-3/31/24 in any US institute in the TrinetX database and had a Z94.0 code. We excluded those with eGFR (calculated via CKD-Epi-2021) with any value <15 or over >150 to reduce risk of misclassification. Outpatient clinic or lab SCr values were used to calculate eGFR with the CKD-Epi 2021 formula. We analyzed the impact of repeated C19D, C19V on eGFR slope with linear mixed models.
Results
Our initial search in TrinetX identified ~13k KTR for consideration in our analysis [Figure] whose age was 54.7 ±16 y/o, baseline eGFR 59.8 ± 27; 43.7% of pts were female; number of SCr, C19D, C19V, follow up time per pt were 15.3 ± 22.6, 0.5 ± 1, 0.79 ± 1.3 , 1063 ± 981 days respectively. Annual loss of eGFR loss before any C19D or C19V was ~1.4 ml/min/1.73m2/year. Statistically significant interactions were noted for any C19D or C19V, with higher annual loss of eGFR after an C19D episode [Table].
Conclusion
Both C19D and C19V may impact the annual loss of eGFR among KTR. Larger studies with longer follow up should be undertaken . Limitations include underdiagnosis of C19D which led to an underestimate of the effects of repeated C19 infections.
Effects of C19D and C19V on eGFR slopes
| eGFR slope among the unvaccinated and the uninfected | -1.42 (-1.65 - -1.19) |
| eGFR slope X 1 C19V | -0.30 (-0.40 - -0.20) |
| eGFR slope X 2 C19V | -0.54 (-0.61 - -0.48) |
| eGFR slope X 3 C19V | -0.43 (-0.52 - -0.35) |
| eGFR x 1 C19D | -0.39 (-0.46 - -0.32) |
| eGFR x 2 C19D | -0.98 (-1.13 - -0.84) |
| eGFR X 3 C19D | -0.73 (-0.87 - -0.58) |
Given as estimates with 95% CI; all p values < 0.001
Funding
- Other NIH Support – DCI, Inc