tetano
Editor, Senior Moderator
BMC Nephrol
. 2025 Feb 11;26(1):71.
doi: 10.1186/s12882-025-04000-x. Risk factors for relapse and aggravation in membranous nephropathy after COVID-19 infection
Yue Shu[SUP] #[/SUP][SUP] 1 [/SUP], Jing Huang[SUP] #[/SUP][SUP] 1 [/SUP], Yi-Miao Zhang[SUP] 1 [/SUP], Fang Wang[SUP] 1 [/SUP], Xin Wang[SUP] 1 [/SUP], Li-Qiang Meng[SUP] 1 [/SUP], Xu-Yang Cheng[SUP] 1 [/SUP], Gang Liu[SUP] 1 [/SUP], Ming-Hui Zhao[SUP] 1 [/SUP], Zhao Cui[SUP] 2 [/SUP]
Affiliations
Background: Relapse of membranous nephropathy (MN) and other glomerular diseases has been observed after COVID-19 infection. The risk factors contributing to disease progression in MN patients after contracting COVID-19 remain unclear.
Methods: This retrospective study included 656 consecutive patients with biopsy-proven primary MN who received treatment and were regularly followed up for over six months. Logistic regression analyses were conducted to identify risk factors for disease progression.
Results: Among the cohort, 555 patients (84.6%) contracted COVID-19 from November 11th, 2022, to February 22nd, 2023. Of them, 112 patients (20.2%) experienced a > 50% increase in proteinuria, including 30 patients (5.4%) who experienced nephrotic syndrome relapse. Sixteen patients (2.9%) showed immune aggravation with elevated anti-PLA2R antibody levels, and five patients (0.9%) had immune relapse characterized by antibody reoccurrence. Kidney dysfunction, defined as an eGFR reduction > 30% from baseline, occurred in 10 patients (1.8%), with two patients (0.4%) progressing to ESKD. Four patients (0.7%) died of respiratory failure. Overall, 132 patients (24.0%) experienced disease progression after COVID-19 infection. Multivariate logistic regression identified longer fever duration (OR 1.118, 95% CI 1.029-1.356, P = 0.018), withdrawal of immunosuppressants and/or steroids (OR 2.571, 95% CI 1.377-4.799, P = 0.003) and extended drug cessation (OR 1.113, 95% CI 1.045-1.186, P = 0.001) as independent risk factors for MN progression.
Conclusions: These findings suggest prompt antiviral treatment and minimizing the duration of immunosuppressant withdrawal to optimize kidney outcomes in MN patients with COVID-19.
Keywords: Aggravation; COVID-19; Membranous nephropathy; Relapse; Risk factors.
. 2025 Feb 11;26(1):71.
doi: 10.1186/s12882-025-04000-x. Risk factors for relapse and aggravation in membranous nephropathy after COVID-19 infection
Yue Shu[SUP] #[/SUP][SUP] 1 [/SUP], Jing Huang[SUP] #[/SUP][SUP] 1 [/SUP], Yi-Miao Zhang[SUP] 1 [/SUP], Fang Wang[SUP] 1 [/SUP], Xin Wang[SUP] 1 [/SUP], Li-Qiang Meng[SUP] 1 [/SUP], Xu-Yang Cheng[SUP] 1 [/SUP], Gang Liu[SUP] 1 [/SUP], Ming-Hui Zhao[SUP] 1 [/SUP], Zhao Cui[SUP] 2 [/SUP]
Affiliations
- PMID: 39934691
- PMCID: PMC11817977
- DOI: 10.1186/s12882-025-04000-x
Background: Relapse of membranous nephropathy (MN) and other glomerular diseases has been observed after COVID-19 infection. The risk factors contributing to disease progression in MN patients after contracting COVID-19 remain unclear.
Methods: This retrospective study included 656 consecutive patients with biopsy-proven primary MN who received treatment and were regularly followed up for over six months. Logistic regression analyses were conducted to identify risk factors for disease progression.
Results: Among the cohort, 555 patients (84.6%) contracted COVID-19 from November 11th, 2022, to February 22nd, 2023. Of them, 112 patients (20.2%) experienced a > 50% increase in proteinuria, including 30 patients (5.4%) who experienced nephrotic syndrome relapse. Sixteen patients (2.9%) showed immune aggravation with elevated anti-PLA2R antibody levels, and five patients (0.9%) had immune relapse characterized by antibody reoccurrence. Kidney dysfunction, defined as an eGFR reduction > 30% from baseline, occurred in 10 patients (1.8%), with two patients (0.4%) progressing to ESKD. Four patients (0.7%) died of respiratory failure. Overall, 132 patients (24.0%) experienced disease progression after COVID-19 infection. Multivariate logistic regression identified longer fever duration (OR 1.118, 95% CI 1.029-1.356, P = 0.018), withdrawal of immunosuppressants and/or steroids (OR 2.571, 95% CI 1.377-4.799, P = 0.003) and extended drug cessation (OR 1.113, 95% CI 1.045-1.186, P = 0.001) as independent risk factors for MN progression.
Conclusions: These findings suggest prompt antiviral treatment and minimizing the duration of immunosuppressant withdrawal to optimize kidney outcomes in MN patients with COVID-19.
Keywords: Aggravation; COVID-19; Membranous nephropathy; Relapse; Risk factors.