Kidney Function Following COVID-19 in Children and Adolescents

• DOI: 10.1001/jamanetworkopen.2025.4129
• Publication Date: 2025-04-11T15:30:31Z
• Authors: Lu Li; Ting Zhou; Yiwen Lu; Jiajie Chen; Yuqing Lei; Qiong Wu; Jonathan Arnold; Michael J. Becich; Yuriy Bisyuk; Saul Blecker; Elizabeth Chrisch...; Dimitri A. Christ...; Carol Reynolds Geary; Ravi Jhaveri; Leslie Lenert; Mei Liu; Parsa Mirhaji; Hiroki Morizono; Abu S. M. Mosa; Ali Mirza Onder; Ruby Patel; William E. Smoyer; Bradley W. Taylor; David A. Williams; Bradley P. Dixon; Joseph T. Flynn; Caroline Gluck; Lyndsay A. Harshman; Mark M. Mitsnefes; Zubin J. Modi; Cynthia G. Pan; Hiren P. Patel; Priya S. Verghese; Christopher B. Fo...; Michelle R. Denburg; Yong Chen; ; Iván Diaz; Rachel Kenney; Jasmin Divers; Lorna Thorpe; Olalekan Bello; Yu Chen; Michelle Lamendol...; Hannah Mandel; Jennifer Truong; Shannon W. Wuller; Sara J. Deakyne D...; Suchitra Rao; L. Charles Bailey; Christopher B. Fo...; Dongkyu Kim; Nathan M Pajor; W. Schuyler Jones; Kelly J Kelleher; Yungui Huang; H Timothy Bunnell; Nathalia Ladino; Daksha Ranade; Alan Schroeder; Susan Kim; Elizabeth A. Chri...; David A. Williams; Abu Saleh Mohamma...; Carol Reynolds Geary; Michael J. Becich; Jonathan Arnold; Yalini Senathirajah; Brian Ostasiewski; Stephen M. Downs; Rainu Kaushal; Thomas R Campion; Selvin Soby; Ravi J Jhaveri; Jyothi Priya Alek...; Curtis Kieler; Bradley W Taylor; Alexander Stoddard; Reza Shaker; Saul Blecker; Marion R. Sills; Keith E. Morse; Mark J. Pletcher; Jim Svoboda; Nickie Cappella; Wei-Qi Wei; Seuli Bose-Brill; Andrew M. Atz; Gail L. Mallett; J. D. Bremner; Lucio Miele

Importance It remains unclear whether children and adolescents with SARS-CoV-2 infection are at heightened risk for long-term kidney complications. Objective To investigate is associated an increased of postacute outcomes among pediatric patients, including those preexisting disease or acute injury (AKI). Design, Setting, Participants This retrospective cohort study used data from 19 health institutions in the National Institutes Health Researching COVID to Enhance Recovery (RECOVER) initiative March 1, 2020, May 2023 (follow-up ≤2 years completed December 2024; index date cutoff, 2022). included (aged <21 years) least 1 baseline visit (24 months 7 days before date) follow-up (28 179 after date). Exposures infection, determined by positive laboratory test results (polymerase chain reaction, antigen, serologic) relevant clinical diagnoses. A comparison group documented negative no history infection. Main Outcomes Measures new-onset chronic (CKD) stage 2 higher CKD 3 without CKD; composite events (≥50% decline estimated glomerular filtration rate [eGFR], eGFR ≤15 mL/min/1.73 m , dialysis, transplant, end-stage diagnosis), 30%, 40%, 50% acute-phase AKI. Hazard ratios (HRs) were using Cox proportional hazards regression models propensity score stratification. Results Among 900 146 patients (487 378 412 768 COVID-19), 969 937 (51.0%) male, mean (SD) age was 8.2 (6.2) years, a range comorbidities represented. (HR, 1.17; 95% CI, 1.12-1.22) 1.35; 1.13-1.62). In CKD, COVID-19 1.15; 1.04-1.27) 28 days. Children AKI had elevated HRs (1.29; 1.21-1.38) 90 outcomes. Conclusions Relevance this large US adolescents, adverse outcomes, particularly AKI, suggesting need vigilant monitoring.