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Research has established the link between COVID-19 infection and renal dysfunction, encompassing acute kidney injury (AKI), glomerular diseases, and chronic kidney disease. Yet, the long-term outcomes for these patients remain underexplored. We studied the clinical features and outcomes of patients recovering from COVID-19, who were referred to an outpatient nephrology clinic for further evaluation.
From July 2021 to October 2022, 45 patients were referred for follow-up at an outpatient nephrology clinic. Baseline characteristics, hospital admission data, and kidney function outcomes were recorded.
Thirty-one patients were hospitalized due to COVID-19 complications, while the remaining were referred following an outpatient-managed episode of COVID-19. The main reasons for referral included COVID-associated AKI, renal dysfunction after COVID-19 on an outpatient basis, and/or urinary abnormalities (hematuria and proteinuria). The median age was 61 (IQR 23 – 86 years), with 53.5% being males. The most frequent comorbidities were arterial hypertension (80%), obesity (55.6%), and diabetes (42.2%). Among those hospitalized, 17 (54.8%) experienced severe AKI requiring dialysis, regaining independent kidney function before discharge. The median hospital stay was 32 days (IQR 16 to 55 days), with a creatinine level at discharge of 1.32 (IQR 1.05 to 1.70 mg/dL). Across the entire group, the prevalence of hematuria was 26.2% and 21.2% had proteinuria > 0.5g/g creatinine. One patient who had nephrotic range proteinuria (4.7g/g creatinine) underwent a kidney biopsy, with a minimal change disease. After a mean follow-up of 164 days (IQR 38 to 458 days), the median creatinine was 1.4 mg/dL (IQR 0.6 to 4.3), and the median eGFR was 49.7 mL/min/1.73m^2 (IQR 12.2 to 118.5). Twenty-six patients (57.8%) had an eGFR below 60 mL/min. Age above 65 years (RR 3.65, CI 95% 1.21 to 10.46) and the presence of more than 3 comorbidities (RR 2.93, CI 95% 1.27 to 6.76) were associated with an eGFR below 60mL/min. One patient eventually required chronic peritoneal dialysis.
Akin to similar reports, this study identified renal dysfunction in a significant proportion of patients after COVID-19 infection, emphasizing the importance of renal monitoring in post-COVID-19 management. A multidisciplinary approach, involving early nephrology referral, regular renal function monitoring, and personalized therapeutic strategies, may mitigate renal sequelae and enhance the quality of life in this patient population. Further research with larger cohorts and extended follow-up is advisable to better elucidate the long-term renal implications of COVID-19.