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

作者：Kankan Shui, Haoran Zhou, Hedong Zhang, Ye Xu, Jiawei Peng, Qiulin Luo, Chen Gao, Gongbin Lan, Fenghua Peng, Shaojie Yu, Xubiao Xie, T J Li, Helong Dai, Longkai Peng · 发表于：European journal of medical research · 年份：2026 · DOI：10.1186/s40001-026-04838-3 · 研究领域：COVID-19 Clinical Research Studies、SARS-CoV-2 and COVID-19 Research、Acute Kidney Injury Research

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. 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. 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). In this real-world 2-year follow-up data for Chinese kidney transp...