Abstract: PUB352
COVID-19 Disease (C19D) and Vaccination (C19V) and the Risk of AKI Among Kidney Transplant (KT) Recipients
Session Information
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Singh, Pooja P., The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- 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, 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
- Roumelioti, Maria-Eleni, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
Background
KT are at increased risk of C19D and a resulting higher risk of AKI, which has also been identified as a potential adverse event from C19V. However the temporal risk of AKI from either C19D or C19V have not been defined in large cohorts.
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. C19V, & C19D were assessed by +ve results in respiratory panel testing (RPT) and the vaccination records in TrinetX. AKI was defined by changes of consecutive SCr values & staged according to KDIGO. Penalized, logistic regression was used to quantify the odds of moderate to severe AKI (msAKI stages 2-3) v.s. stage 1 relative to the timing of C19D, RPT and C19V
Results
We searched 14M records to include 14,222 KT with characteristics shown in [Table]. There were over 25000 AKI episodes, 93% of which were stage 1. The risk for msAKI vs mild AKI was high for 2 months after ANY RPT (Figure, middle); a positive C19 test appeared to be associated with an additional risk but uncertainty was high. There was no apparent association between timing of C19V and msAKI.
Conclusion
KT are at high risk for AKI after respiratory illness; further studies are warranted to determine if a C19D increases the risk further and by how much. C19V does not change the risk of AKI.
Demographics
| Age | 56.19 (15.38) |
| Gender (Female) | 6431 ( 44.6) |
| Baseline eGFR (on cohort entry, ml/min/1.73m2) | 62.85 (26.69) |
| Creatinine Values/individual | 27.18 (36.28) |
| Number of AKI/individual | 1.78 (3.03) |
| Number of C19V/individual | 0.70 (1.26) |
| Number of C19D/individual | 0.47 (0.97) |
| Number of RPT/individual | 2.08 (2.20) |
| AKI stage 1 | 23908 (93.3) |
| AKI stage 2-3 (moderate to severe) | 1715 (6.7) |
Presented as means (SD) or N(%)
Odds of msAKI v.s. C19D, need for RPT and C19V
Funding
- Other NIH Support – DCI, Inc