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Infectious Diseases

Updated 17 September 2020

Covid-19 takes heavy toll on kidneys

Researchers are grappling with a great deal of uncertainty as to how SARS-CoV-2 will impact the kidneys in the long haul.

  • There may be an epidemic of post-Covid-19 kidney disease
  • This could mean many more patients who require kidney dialysis and even transplants
  • The first priority of doctors must be to identify patients early and try to stop the development of kidney disease


Covid-19 can damage the kidneys and increase patients' risk of needing kidney dialysis, researchers report.

The study authors also warned that doctors should prepare for a significant rise in chronic kidney disease cases due to the pandemic.

For the study, the investigators analysed data from nearly 4 000 Covid-19 patients, aged 18 and older, hospitalised at the Mount Sinai Health System in New York City between 27 February and 30 May, 2020.

Acute kidney injury (AKI) occurred in 46% of the patients, and one-fifth of those required dialysis, according to the study published on 3 September in the Journal of the American Society of Nephrology.

Dialysis and even transplants

The in-hospital death rate was 50% among those with AKI, compared with 8% among those who didn't have AKI. Only 30% of those who developed AKI survived and had kidney recovery, the findings showed.

"We are grappling with a great deal of uncertainty as to how the virus will impact the kidneys in the long haul," said principal investigator Dr Girish Nadkarni. He is co-director of the Covid Informatics Center and an assistant professor of medicine (nephrology) at the Icahn School of Medicine at Mount Sinai, in New York City.

"We may be facing an epidemic of post-Covid-19 kidney disease, and that, in turn, could mean much greater numbers of patients who require kidney dialysis and even transplants," Nadkarni said in a Mount Sinai news release.

Senior study author Benjamin Glicksberg is an assistant professor of genetics and genomic sciences at the Icahn School of Medicine and Institute for Digital Health.

Glicksberg said, "In light of the data we have collected about AKI and other kidney abnormalities associated with Covid-19, our first priority must be to identify patients early and disrupt the progression of kidney disease. We are currently using machine learning to build models that can predict outcomes such as these, which will be assessed within Mount Sinai and disseminated to other hospitals across the country."

Nadkarni added that "the sheer number of AKI cases, and the overwhelming need for dialysis that we are seeing in the context of Covid-19, is unprecedented. These findings may help health systems prepare for the high rates of renal dysfunction in incoming Covid-19 patients."

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