ArticleCommunications medicine2026
The risk of kidney disease increases following SARS-CoV-2 infection compared to influenza.
Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough case reports and observational studies suggest COVID-19 increases the risk of kidney diseases, real-world evidence comparing it with influenza is limited. Our study aims to assess the association between COVID-19 infections and subsequent kidney diseases, using influenza as a positive control and incorporating a negative control to establish clearer associations.
methodsA large retrospective cohort study with strata matching was conducted using the MarketScan database with records from Jan. 2020 to Dec. 2021. We used the ICD-10 codes to identify individuals and build three cohorts: (1) COVID-19 group, (2) Positive control group: Influenza but no COVID-19, and (3) Negative control group: no COVID-19 / Influenza. The outcomes were acute kidney injury (AKI), chronic kidney disease (CKD), end-stage renal disease (ESRD), and glomerular diseases. Multivariable stratified Cox proportional hazards regression analyses were performed.
resultsThe study includes 939,241 individuals with COVID-19, 1,878,482 individuals in the negative control group, and 199,071 individuals with influenza. COVID-19 is significantly associated with increased risks of AKI (adjusted hazards ratio, aHR: 2.74; 95% CI, 2.61-2.87), CKD (aHR: 1.38, 1.32-1.45), ESRD (aHR: 3.22, 2.67-3.88), and glomerular diseases (aHR:1.28, 1.09-1.50), while influenza has no impact on CKD, ESRD, and glomerular diseases. Time-specific analyses indicate that COVID-19 has stronger effects on AKI in the short term but has stable long-term effects on CKD.
conclusionsIn this large real-world study of working-age, commercially insured adults in the United States, COVID-19 infection is associated with a 2.3-fold risk of developing AKI, a 1.4-fold risk of CKD, and a 4.7-fold risk of ESRD compared to influenza. Greater attention to kidney diseases post-COVID-19 is essential to prevent future adverse health outcomes.
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