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Background <p>Clinical characteristics and 2-year outcomes of COVID-19-associated acute kidney injury (AKI) during the Omicron wave in Chinese kidney transplant recipients are lacking. This study aimed to investigate the clinical features and 2-year outcomes of COVID-19-associated AKI in this population.</p> Methods <p>A retrospective analysis was performed on 316 kidney transplant recipients hospitalized with COVID-19 between December 2022 and August 2023. Patients were divided into AKI (<i>n</i> = 117) and non-AKI (<i>n</i> = 199) groups to compare the clinical characteristics and 2-year outcomes.</p> Results <p>Among kidney transplant recipients with COVID-19, the AKI group had significantly higher baseline creatinine levels (<i>p</i> &lt; 0.001) and a higher risk of graft loss (<i>p</i> &lt; 0.001) compared to the non-AKI group. At 1, 3, 6, 12, and 24&#xa0;month post-COVID-19 infection, serum creatinine levels were significantly higher (all <i>p</i> &lt; 0.001) and estimated glomerular filtration rate (eGFR) was significantly lower (all <i>p</i> &lt; 0.001) in the AKI group. Multivariate Cox regression analysis identified AKI (hazard ratio [HR] = 4.325, 95% confidence interval [CI] 1.155–16.192, <i>p</i> = 0.03), baseline creatinine (HR = 1.014, 95% CI 1.009–1.020, <i>p</i> &lt; 0.001), and invasive fungal infection (HR = 3.333, 95% CI 1.447–7.678, <i>p</i> = 0.005) as independent risk factors for 2-year graft survival. ROC analysis indicated these three factors provided good prognostic performance for graft loss (AUC = 0.91).</p> Conclusions <p>In this real-world 2-year follow-up data for Chinese kidney transplant recipients, our study indicated that COVID-19-associated AKI during the Omicron wave is strongly associated with inferior 2-year graft outcomes, particularly in recipients with pre-existing graft dysfunction.</p>

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Clinical characteristics and 2-year outcomes of hospitalized kidney transplant recipients with COVID-19-associated acute kidney injury during the omicron wave: a Chinese cohort study

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  • 发表日期：

    2026年7月6日

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  • Kankan Shui,
  • Haoran Zhou,
  • Hedong Zhang,
  • Ye Xu,
  • Jiawei Peng,
  • Qiulin Luo,
  • Chen Gao,
  • Gongbin Lan,
  • Fenghua Peng,
  • Shaojie Yu,
  • Xubiao Xie,
  • Tengfang Li,
  • Helong Dai,
  • Longkai Peng

摘要

Background

Clinical characteristics and 2-year outcomes of COVID-19-associated acute kidney injury (AKI) during the Omicron wave in Chinese kidney transplant recipients are lacking. This study aimed to investigate the clinical features and 2-year outcomes of COVID-19-associated AKI in this population.

Methods

A retrospective analysis was performed on 316 kidney transplant recipients hospitalized with COVID-19 between December 2022 and August 2023. Patients were divided into AKI (n = 117) and non-AKI (n = 199) groups to compare the clinical characteristics and 2-year outcomes.

Results

Among kidney transplant recipients with COVID-19, the AKI group had significantly higher baseline creatinine levels (p < 0.001) and a higher risk of graft loss (p < 0.001) compared to the non-AKI group. At 1, 3, 6, 12, and 24 month post-COVID-19 infection, serum creatinine levels were significantly higher (all p < 0.001) and estimated glomerular filtration rate (eGFR) was significantly lower (all p < 0.001) in the AKI group. Multivariate Cox regression analysis identified AKI (hazard ratio [HR] = 4.325, 95% confidence interval [CI] 1.155–16.192, p = 0.03), baseline creatinine (HR = 1.014, 95% CI 1.009–1.020, p < 0.001), and invasive fungal infection (HR = 3.333, 95% CI 1.447–7.678, p = 0.005) as independent risk factors for 2-year graft survival. ROC analysis indicated these three factors provided good prognostic performance for graft loss (AUC = 0.91).

Conclusions

In this real-world 2-year follow-up data for Chinese kidney transplant recipients, our study indicated that COVID-19-associated AKI during the Omicron wave is strongly associated with inferior 2-year graft outcomes, particularly in recipients with pre-existing graft dysfunction.