Impact of COVID-19 on chronic kidney disease progression in non-dialysis patients: a retrospective cohort study in Palestine.

BACKGROUND

This study aims to evaluate the impact of COVID-19 on the progression of CKD in non-dialysis patients and its relation to clinical outcomes in Palestine.

MATERIALS AND METHODS

We conducted a retrospective cohort study that followed non-dialysis CKD patients receiving treatment at outpatient clinics in governmental hospitals. Out of the 248 CKD patients who met the inclusion criteria, 98 were diagnosed with COVID-19 between March 2020 and March 2022. We collected data at three distinct time intervals, both prior to and after their COVID-19 infection. We examined the decline in eGFR and gathered demographic information, hospitalization, and mortality rates. The drop in eGFR was recorded 15 months from baseline.

RESULTS

The mean age of the patients was 55 years, with 55.6% being male. Patients diagnosed with COVID-19 faced a significantly higher risk of rapid deterioration in eGFR, with a 3.7-fold increase compared to those without COVID-19 (a-value: <0.001; aOR: 3.7; 95% CI: 2.1-6.3). Additionally, COVID-19 patients had 4.4 times higher mortality rates (a-value: 0.005; aOR: 4.4; 95% CI: 1.6-12.4), 13.3 times higher rates of dialysis initiation within 15 months post-baseline (a-value: <0.001; aOR: 13.3; 95% CI: 6.1-28.7), and 3.5 times higher rates of hospital admissions (a-value: <0.001; aOR: 3.5; 95% CI: 1.8-6.7) compared to the COVID-19 negative group.

CONCLUSION

CKD patients who contract COVID-19 experience a more rapid decline in kidney function, leading to worse health outcomes, including increased mortality rates, a greater need for dialysis, and higher hospitalization rates.