Results from the IRoc-GN international registry of patients with COVID-19 and glomerular disease suggest close monitoring

Waldman, M. et al. (2021) Results from the IRoc-GN international registry of patients with COVID-19 and glomerular disease suggest close monitoring. Kidney International, 99(1), pp. 227-237. (doi: 10.1016/j.kint.2020.10.032) (PMID:33181156) (PMCID:PMC7833801)

Abstract

The effects of SARS-CoV-2 infection on individuals with immune-mediated glomerulonephritis, who are often undergoing immunosuppressive treatments, are unknown. Therefore, we created the International Registry of COVID infection in glomerulonephritis (IRoc-GN) and identified 40 patients with glomerulonephritis and COVID-19 followed in centers in North America and Europe. Detailed information on glomerulonephritis diagnosis, kidney parameters, and baseline immunosuppression prior to infection were recorded, as well as clinical presentation, laboratory values, treatment, complications, and outcomes of COVID-19. This cohort was compared to 80 COVID-positive control cases from the general population without glomerulonephritis matched for the time of infection. The majority (70%) of the patients with glomerulonephritis and all the controls were hospitalized. Patients with glomerulonephritis had significantly higher mortality (15% vs. 5%, respectively) and acute kidney injury (39% vs. 14%) than controls, while the need for kidney replacement therapy was not statistically different between the two groups. Receiving immunosuppression or renin-angiotensin-aldosterone system inhibitors at presentation did not increase the risk of death or acute kidney injury in the glomerulonephritis cohort. In the cohort with glomerulonephritis, lower serum albumin at presentation and shorter duration of glomerular disease were associated with greater risk of acute kidney injury and need for kidney replacement therapy. No differences in outcomes occurred between patients with primary glomerulonephritis versus glomerulonephritis associated with a systemic autoimmune disease (lupus or vasculitis). Thus, due to the higher mortality and risk of acute kidney injury than in the general population without glomerulonephritis, patients with glomerulonephritis and COVID-19 should be carefully monitored, especially when they present with low serum albumin levels.

• Item Type: Articles
• Additional Information: This research was supported in part by the Intramural Research Program of the NIH, NIDDK, and by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London.
• Keywords: AKI, COVID-19, glomerulonephritis, IRoc-GN, proteinuria, SARS-CoV-2.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Geddes, Dr Colin
• Authors: Waldman, M., Soler, M. J., García-Carro, C., Lightstone, L., Turner-Stokes, T., Griffith, M., Torras, J., Valenzuela, L. M., Bestard, O., Geddes, C., Flossmann, O., Budge, K. L., Cantarelli, C., Fiaccadori, E., Delsante, M., Morales, E., Gutierrez, E., Niño-Cruz, J. A., Martinez-Rueda, A. J., Comai, G., Bini, C., La Manna, G., Slon, M. F., Manrique, J., Agraz, I., Sinaii, N., and Cravedi, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Kidney International
• Publisher: Elsevier
• ISSN: 0085-2538
• ISSN (Online): 1523-1755
• Published Online: 09 November 2020