Researchers Warn of Post-COVID-19 Kidney Disease Epidemic Linked to SARS-CoV-2

A new study of patients hospitalized with COVID-19 has revealed that nephrologists will need to prepare for a significant uptick in patients with chronic kidney disease linked to exposure to the SARS-CoV-2 virus.

Researchers from the Icahn School of Medicine at Mount Sinai (ISMMS New York, NY, USA) conducted a retrospective observational study of 3,993 Mount Sinai Health System patients hospitalized from February 27, to May 30, 2020, reviewing data from electronic health records of patients older than 18 years with laboratory confirmed COVID-19. Their findings revealed troubling consequences of COVID-19 on the kidneys, including acute kidney injury (AKI), which occurred in 46% of hospitalized patients, one fifth of whom required dialysis. Most striking, in-hospital mortality was 50% among patients with AKI, versus 8% of patients hospitalized with COVID-19 who did not develop AKI. Only 30% of patients who were hospitalized with COVID-19 and developed AKI survived and experienced renal recovery. The study also suggests an increasing risk of death among higher stages of AKI, with the highest risk seen in patients with stage 3 AKI who required dialysis.

“We are grappling with a great deal of uncertainty as to how the virus will impact the kidneys in the long haul,” said principal investigator, Girish Nadkarni, MD. “We may be facing an epidemic of post-COVID-19 kidney disease, and that, in turn, could mean much greater numbers of patients who require kidney dialysis and even transplants.”

“These findings bring clinical evidence to the hypothesis of lingering organ dysfunction among patients recovering from COVID-19 and serve as a reminder to hospitals around the country to be very strategic in the allocation of resources to care for patients who experience acute kidney injury,” added Dr. Nadkarni, who is Co-Director of the COVID Informatics Center, Clinical Director of the Hasso Plattner Institute for Digital Health and Assistant Professor of Medicine (Nephrology) at the Icahn School of Medicine at Mount Sinai.

"In light of the data we have collected about acute kidney injury (AKI) and other kidney abnormalities associated with COVID-19, our first priority must be to identify patients early and disrupt the progression of kidney disease. We are currently using machine learning to build models that can predict outcomes such as these which will be assessed within Mount Sinai and disseminated to other hospitals across the country," said Benjamin Glicksberg, PhD, a senior author of the study, Assistant Professor of Genetics and Genomic Sciences at the Icahn School of Medicine at Mount Sinai and the Hasso Plattner Institute for Digital Health.

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