Are patients with Covid-19 at risk of long-term chronic kidney disease?

Background: The relationship between Coronavirus Disease 2019 (COVID-19) and acute kidney injury (AKI) is well-established. However, a comprehensive evaluation of kidney outcomes in the long-term course of COVID-19 is not yet been performed. The aim of this study is to investigate whether chronic kidney disease (CKD) develops within six months after hospital discharge in COVID-19 patients who did not have kidney damage at the time of admission to the hospital. Patients and Methods: This single-center retrospective study investigated a total of 1008 participants selected from 7500 COVID-19 patients with real-time reverse transcription-polymerase chain reaction (RT-PCR) positivity. All patients had mild/moderate or severe COVID-19. Patients were randomly selected from inpatient and outpatient settings. Critical COVID-19 patients were not included. Results: The mean age of the patients was 56.57 ± 16.30 years, and 69.9% of them were male. The comorbidity percentages of the participants were as follows; 19.5% coronary artery disease (CAD), 28.6% diabetes mellitus (DM), 36.2% hypertension (HT), 3.1% cerebrovascular obstruction (CVO), 1.7% malignancy, 2.6% chronic obstructive pulmonary disease (COPD), 9.4% asthma, % 1.7 dementia, 9.9% hyperlipidaemia, and 1.7% hepatitis B virus (HBV). Kidney function tests of these patients at first admission and 6 months later were compared to reveal the relationship between COVID-19 and CKD. Serum glucose, sodium estimated glomerular filtration rate (eGFR), and uric acid levels were found to be high in the post-COVID-19 period (P = 0.001). However, there were a decrease in serum albumin, potassium, alanine aminotransferase (ALT), C-reactive protein (CRP), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and gamma-glutamyl transferase (GGT) levels (P = 0.001). The difference between the first measurement of serum urea and creatinine (Cr) levels and the measurement 6 months later was not statistically significant (P = 0.102 and P = 0.300, respectively). Conclusions: Those who survived the mild/moderate and severe clinical manifestations of COVID-19 did not exhibit any risk of kidney outcomes after the acute phase of the disease, suggesting that the kidney can protect itself over a long period of time.

Relationship between acute kidney injury requiring renal replacement treatment and mortality in patients with COVID-19.

Background: It has been reported that the most affected organ by the coronavirus disease 2019 (COVID-19) is the lung, closely followed by the kidney. Aim: Over the course of the COVID-19, the factors affecting mortality in acute kidney injury requiring renal replacement therapy (AKI-RRRT) have not been known. This study was conducted in order to shed light on this issue. Patients and Methods: There were 64 patients in total. Subjects were divided into two groups. Group 1 consisted of a control group that comprised 33 subjects who did not have AKI during the time in which they were infected with COVID-19. Group 2 was COVID-19 related AKI requiring renal replacement therapy (COVID-19 AKI-RRRT), which included 31 subjects who were exposed to AKI-RRRT. Results: In Group 2, 27 (87%) patients died and 4 (13%) patients were recovered. The predominance of comorbidity and presence of more than one additional disease (p < 0.05), the excessive number of inpatients in intensive care unit (ICU) (p < 0.05), high mortality rates (p < 0.05), advanced age (p < 0.05), and long hospitalization periods (p < 0.05) were evident in Group 2. Serum levels of variables such as white blood cells (WBC), neutrophils, C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, glucose, lactate dehydrogenase (LDH), and prothrombin time (PT) were high for patients in the Group 2 (p < 0.05) group. However, serum levels of lymphocyte, hemoglobin (HGB), and albumin were low. Conclusions: It can be argued that COVID-19 AKI-RRRT is associated with higher mortality.