2025/10/01 by Amir Ali Ahmadzadeh, Christos Argyropoulos, Pooja P. Singh +4 · 1 voice
Medicine · #Heparin-Induced Thrombocytopenia and Thrombosis #COVID-19 Clinical Research Studies #Renal Transplantation Outcomes and Treatments
paper · doi:10.1681/asn.2025tmd0xb1j
Background: While case reports have linked C19D & C19V with glomerulonephritides and AKI among the general population and KTR, little is known about the population effects of C19D and C19V on loss of eGFR over time in KTR. Methods: We included all patients who had a C19 test between 3/1/20-3/31/24 in any US institute in the TrinetX database and had a Z94.0 code. We excluded those with eGFR (calculated via CKD-Epi-2021) with any value <15 or over >150 to reduce risk of misclassification. Outpatient clinic or lab SCr values were used to calculate eGFR with the CKD-Epi 2021 formula. We analyzed the impact of repeated C19D, C19V on eGFR slope with linear mixed models. Results: Our initial search in TrinetX identified ~13k KTR for consideration in our analysis [Figure] whose age was 54.7 ±16 y/o, baseline eGFR 59.8 ± 27; 43.7% of pts were female; number of SCr, C19D, C19V, follow up time per pt were 15.3 ± 22.6, 0.5 ± 1, 0.79 ± 1.3 , 1063 ± 981 days respectively. Annual loss of eGFR loss before any C19D or C19V was ~1.4 ml/min/1.73m2/year. Statistically significant interactions were noted for any C19D or C19V, with higher annual loss of eGFR after an C19D episode [Table]. Conclusion: Both C19D and C19V may impact the annual loss of eGFR among KTR. Larger studies with longer follow up should be undertaken . Limitations include underdiagnosis of C19D which led to an underestimate of the effects of repeated C19 infections. Funding: Other NIH Support - NCATS, UL1TR001449, Commercial Support - DCI, Inc, Effects of C19D and C19V on eGFR slopes - eGFR slope among the unvaccinated and the uninfected -1.42 (-1.65 - -1.19) eGFR slope X 1 C19V -0.30 (-0.40 - -0.20) eGFR slope X 2 C19V -0.54 (-0.61 - -0.48) eGFR slope X 3 C19V -0.43 (-0.52 - -0.35) eGFR x 1 C19D -0.39 (-0.46 - -0.32) eGFR x 2 C19D -0.98 (-1.13 - -0.84) eGFR X 3 C19D -0.73 (-0.87 - -0.58) Given as estimates with 95% CI; all p values < 0.001