Long-Term Impact Of Sars-Cov-2 Infection On The Progression Of Chronic Kidney Disease: Retrospective Study Of A National Multicenter Cohort

Background: The chronic consequences of COVID-19 in patients with pre-existing chronic kidney disease (CKD) remain a global concern, particularly in low-and middle-income countries where healthcare resources are limited.This study evaluated the long-term effects of SARS-CoV-2 infection on CKD progression over 36 months.Methods: In this multicenter retrospective study, 58 CKD patients with confirmed SARS-CoV-2 infection (COVID-positive) were compared with 54 CKD patients without a history of infection (COVID-negative), matched for age, sex, and timing of follow-up recruited from eight nephrology institutions.Clinical and laboratory data, comorbidities, and vaccination status were analyzed.Kidney function was assessed by annual estimated glomerular filtration rate (eGFR) slope.Results: COVID-positive patients showed a significantly greater median annual eGFR decline than COVID negative ones (-4.0 vs. -1.5 ml/ min/1.73m², P = 0.005).Furthermore, the proportion of rapid progression was significantly higher in the COVID-positive group (51.7% vs. 22.2%, P = 0.0008), indicating a more aggressive CKD trajectory following SARS-CoV-2 infection.Using threshold of ≤ -4 ml/min/1.73m²/year, COVID-19 infection independently conferred 3.7-fold higher odds of rapid GFR progression.Regression analysis identified COVID-19 infection and baseline eGFR as independent predictors of rapid decline.Conclusion: SARS-CoV-2 infection, regardless of COVID severity, significantly worsens long-term kidney outcomes in CKD patients.These findings emphasize the importance of early preventive strategies, vaccination coverage, and closer follow-up in this vulnerable population.