tetano
Editor, Senior Moderator
Transpl Int
. 2021 Apr 21.
doi: 10.1111/tri.13886. Online ahead of print.
Recovery of kidney function after AKI due to COVID-19 in kidney transplant recipients
Divya Bajpai[SUP] 1 [/SUP], Satarupa Deb[SUP] 1 [/SUP], Sreyashi Bose[SUP] 1 [/SUP], Chintan Gandhi[SUP] 1 [/SUP], Tulsi Modi[SUP] 1 [/SUP], Abhinav Katyal[SUP] 1 [/SUP], Nikhil Saxena[SUP] 1 [/SUP], Ankita Patil[SUP] 1 [/SUP], Sayali Thakare[SUP] 1 [/SUP], Atim E Pajai[SUP] 1 [/SUP], Ashwathy Haridas[SUP] 2 [/SUP], Vaibhav S Keskar[SUP] 3 [/SUP], Sunil Y Jawale[SUP] 4 [/SUP], Amar G Sultan[SUP] 5 [/SUP], Tukaram E Jamale[SUP] 1 [/SUP]
Affiliations
Abstract
Evidence on the evolution of graft function in kidney transplant recipients recovering from Coronavirus disease - 2019 (COVID- 19) is lacking. This multicenter observational study evaluated the short-term clinical outcomes in recipients with acute kidney injury (AKI) secondary to COVID-19. Out of 452 recipients following up at 5 centers, 50 had AKI secondary to COVID-19. 42 recipients with at least 3 months follow-up were included. Median follow-up was 5.23 months [IQR 4.09-6.99]. Severe COVID-19 was seen in 21 (50%) and 12 (28.6%) had KDIGO stage-3 AKI. Complete recovery of graft function at 3 months was seen in 17 (40.5%) patients. Worsening of proteinuria was seen in 15 (37.5%) patients and 4 (9.5%) patients had new-onset proteinuria. Graft failure was seen in 6 (14.3%) patients. Kidney biopsy revealed acute tubular injury (9/11 patients), thrombotic microangiopathy (2/11), acute cellular rejection (2/11), and chronic active antibody-mediated rejection (3/11). Patients with incomplete recovery were likely to have lower eGFR and proteinuria at baseline, historical allograft rejection, higher admission SOFA score, orthostatic hypotension, and KDIGO stage 3 AKI. Baseline proteinuria and the presence of orthostatic hypotension independently predicted incomplete graft recovery. This shows that graft recovery may remain incomplete in AKI secondary to COVID 19.
Keywords: AKI; COVID-19; Kidney transplantation; Outcomes; graft function; recovery.
. 2021 Apr 21.
doi: 10.1111/tri.13886. Online ahead of print.
Recovery of kidney function after AKI due to COVID-19 in kidney transplant recipients
Divya Bajpai[SUP] 1 [/SUP], Satarupa Deb[SUP] 1 [/SUP], Sreyashi Bose[SUP] 1 [/SUP], Chintan Gandhi[SUP] 1 [/SUP], Tulsi Modi[SUP] 1 [/SUP], Abhinav Katyal[SUP] 1 [/SUP], Nikhil Saxena[SUP] 1 [/SUP], Ankita Patil[SUP] 1 [/SUP], Sayali Thakare[SUP] 1 [/SUP], Atim E Pajai[SUP] 1 [/SUP], Ashwathy Haridas[SUP] 2 [/SUP], Vaibhav S Keskar[SUP] 3 [/SUP], Sunil Y Jawale[SUP] 4 [/SUP], Amar G Sultan[SUP] 5 [/SUP], Tukaram E Jamale[SUP] 1 [/SUP]
Affiliations
- PMID: 33884672
- DOI: 10.1111/tri.13886
Abstract
Evidence on the evolution of graft function in kidney transplant recipients recovering from Coronavirus disease - 2019 (COVID- 19) is lacking. This multicenter observational study evaluated the short-term clinical outcomes in recipients with acute kidney injury (AKI) secondary to COVID-19. Out of 452 recipients following up at 5 centers, 50 had AKI secondary to COVID-19. 42 recipients with at least 3 months follow-up were included. Median follow-up was 5.23 months [IQR 4.09-6.99]. Severe COVID-19 was seen in 21 (50%) and 12 (28.6%) had KDIGO stage-3 AKI. Complete recovery of graft function at 3 months was seen in 17 (40.5%) patients. Worsening of proteinuria was seen in 15 (37.5%) patients and 4 (9.5%) patients had new-onset proteinuria. Graft failure was seen in 6 (14.3%) patients. Kidney biopsy revealed acute tubular injury (9/11 patients), thrombotic microangiopathy (2/11), acute cellular rejection (2/11), and chronic active antibody-mediated rejection (3/11). Patients with incomplete recovery were likely to have lower eGFR and proteinuria at baseline, historical allograft rejection, higher admission SOFA score, orthostatic hypotension, and KDIGO stage 3 AKI. Baseline proteinuria and the presence of orthostatic hypotension independently predicted incomplete graft recovery. This shows that graft recovery may remain incomplete in AKI secondary to COVID 19.
Keywords: AKI; COVID-19; Kidney transplantation; Outcomes; graft function; recovery.