Relationship between infectious disease epidemic trends and kidney disease incidence: Impact of the COVID-19 pandemic

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Abstract Title *

Relationship between infectious disease epidemic trends and kidney disease incidence: Impact of the COVID-19 pandemic

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Co-author 1

Yuka Sato sa-yuka@dokkyomed.ac.jp Dokkyo Medical University Department of Nephrology & Hypertension Tochigi Japan *

Co-author 2

Makoto Abe m-abe@dokkyomed.ac.jp Dokkyo Medical University Department of Nephrology & Hypertension Tochigi Japan -

Co-author 3

Jun Hirao hirao-j@dokkyomed.ac.jp Dokkyo Medical University Department of Nephrology & Hypertension Tochigi Japan -

Co-author 4

Tadayuki Ogawa t-ogawa700@dokkyomed.ac.jp Dokkyo Medical University Department of Nephrology & Hypertension Tochigi Japan -

Co-author 5

Akihiro Tojo akitojo@dokkyomed.ac.jp Dokkyo Medical University Department of Nephrology & Hypertension Tochigi Japan -

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Introduction

Renal disease incidence rates determined by renal biopsy fluctuate over time and are partially correlated with sentinel monitoring of infectious diseases. The COVID-19 pandemic has changed lifestyle patterns and infectious disease trends, and we investigated the correlation with renal disease incidence rates.

Methods

We calculated the 11-year mean and standard deviation (SD) of annual diagnoses in our department's renal biopsy data from 2014 to 2024, as well as the number of syphilis cases and sentinel monitoring data from the National Institute of Infectious Diseases. The Mann-Kendall test was used to examine correlations and variability in SD values for each renal disease and pathogen. Bacteria in urinary sediments from patients with IgA nephropathy were identified using MALDY-TOF-MS mass spectrometry.

Results

After the COVID-19 pandemic, IgA nephropathy and focal segmental glomerulosclerosis (FSGS) increased. IgA nephropathy was highly correlated with genital herpes (r=0.87) and syphilis (r=0.80), and the correlation with fluctuations was significant. The increase in FSGS was significantly correlated with genital chlamydia. After the COVID-19 pandemic, kidney biopsies for crescentic glomerulonephritis and diabetic nephrosclerosis decreased, which significantly correlated with the reduced prevalence of airborne viruses due to mask wearing. A 50% likelihood analysis using specific ribosomal proteins was performed on 10 of 23 urine specimens with IgA nephropathy using MALDY-TOF-MS. Oral streptococci, Staphylococcus aureus, and Enterobacteriaceae were identified, some of which possessed IgA protease activity.

Conclusion

The COVID-19 pandemic has led to lifestyle changes, altering the incidence of kidney disease and infectious disease epidemics. Especially, the incidence of IgA nephropathy has increased following the COVID-19 pandemic, which is associated with sexually transmitted infections, and oral and intestinal bacteria have been identified in urine.

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