Frediani Marcella M, Ribeiro Heitor S, Busatto Geraldo F, Carvalho Carlos R R, Burdmann Emmanuel A
Laboratório de Investigação 12, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Kidney Med. 2025 May 29;7(8):101039. doi: 10.1016/j.xkme.2025.101039. eCollection 2025 Aug.
RATIONALE & OBJECTIVE: Whether long coronavirus disease (long COVID) affects the kidneys remains to be understood. In this scoping review, we described the evidence of renal long COVID.
A scoping review was conducted according to the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines by searching MEDLINE, Embase, and other databases from inception until February 2025.
SETTING & STUDY POPULATIONS: We included evidence on kidney-related outcomes in adult survivors of coronavirus disease 2019 (COVID-19) with data on long COVID.
Cohorts from all settings.
We extracted data related to longitudinal kidney outcomes.
Data were synthesized and presented in tables and figures.
We screened 6,203 studies and included 37 in this review (38 reports), comprising 1,308,265 individuals with follow-up data. The majority were retrospective (61%) and from Europe (37%). All reports included hospitalized patients and 34% also included the community setting. Acute kidney injury (AKI) during acute COVID-19 phase was assessed in 58% of the reports. Chronic kidney disease (CKD) development was assessed in 29% of the reports, with wide variation in its frequency, ranging from 0.4%-45%. Progression of CKD (7 studies, 18%) ranged from 8%-49%. Studies reporting higher frequencies of AKI found larger rates of renal long COVID. Overall, there was high heterogeneity in how kidney-related outcomes were reported during follow-up. Most studies presented data on crude kidney function biomarkers (eg, serum creatinine or estimated glomerular filtration rate), while a few (13%) reported major adverse kidney events. Data on proteinuria or urinary biomarkers were scarce.
Lack of studies with pre-COVID-19 data.
This scoping review highlighted that renal long COVID, characterized by CKD development and/or progression, may occur. Available evidence suggests that AKI may be associated with renal long COVID. Therefore, long-term kidney function monitoring is advisable after COVID-19 recovery to enable early diagnosis and timely intervention for CKD.
新冠长期症状（长新冠）是否会影响肾脏仍有待明确。在本综述中，我们描述了有关长新冠肾脏影响的证据。
根据乔安娜·布里格斯研究所的指南以及系统评价与Meta分析扩展版的范围综述报告规范，对MEDLINE、Embase和其他数据库进行检索，检索时间跨度从数据库创建至2025年2月，以此进行范围综述。
我们纳入了有关2019冠状病毒病（COVID-19）成年幸存者肾脏相关结局的证据，这些幸存者有长新冠的数据。
来自所有背景的队列研究。
我们提取了与肾脏纵向结局相关的数据。
数据进行了综合，并以表格和图表形式呈现。
我们筛选了6203项研究，本综述纳入了37项（38份报告），涉及1308265名有随访数据的个体。大多数研究是回顾性的（61%），且来自欧洲（37%）。所有报告均纳入了住院患者，34%的报告还纳入了社区背景的患者。58%的报告评估了急性COVID-19阶段的急性肾损伤（AKI）。29%的报告评估了慢性肾脏病（CKD）的发生情况，其发生率差异很大，从0.4%到45%不等。CKD的进展情况（7项研究，18%）在8%至49%之间。报告AKI发生率较高的研究发现长新冠肾脏影响的发生率也较高。总体而言，随访期间肾脏相关结局的报告方式存在高度异质性。大多数研究呈现了粗略的肾功能生物标志物数据（如血清肌酐或估算肾小球滤过率），而少数研究（13%）报告了主要不良肾脏事件。蛋白尿或尿液生物标志物的数据很少。
缺乏COVID-19之前的数据的研究。
本范围综述强调，以CKD发生和/或进展为特征的长新冠肾脏影响可能会出现。现有证据表明，AKI可能与长新冠肾脏影响有关。因此，建议在COVID-19康复后进行长期肾功能监测，以便对CKD进行早期诊断和及时干预。
