ArticleBMJ open2026
Persistent increased risk of renal replacement therapy following COVID-19: a 2-year follow-up study in Japan using propensity score matching and inverse probability censoring weighting.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
backgroundThis retrospective cohort study investigated the long-term risk of end-stage kidney disease (ESKD) following COVID-19 using a nationwide database of Japanese medical claims.
methodsPropensity score matching was utilised to form a cohort of individuals with COVID-19 and a non-infected control group using data from the National Claims Database encompassing six prefectures in Japan. The primary outcome measured was the initiation of renal replacement therapy (dialysis or kidney transplantation) after the index month of the study period. Cox proportional hazards models incorporating inverse probability of censoring weighting were employed to estimate HRs for the association between COVID-19 and ESKD.
resultsA total of 3 073 150 pairs were matched in this study. During follow-up, COVID-19 was associated with a significantly increased instantaneous risk of the composite ESKD outcome (HR 2.79, 95% CI 2.56 to 3.04). The risk was increased for haemodialysis initiation (HR 2.77, 95% CI 2.54 to 3.02) and peritoneal dialysis (HR 5.16, 95% CI 1.93 to 13.75), whereas the estimate for kidney transplantation was imprecise (HR 5.20, 95% CI 0.62 to 43.27). Subgroup analyses showed broadly consistent associations across age, sex, hypertension, diabetes and COVID-19 severity.
conclusionThese findings suggest that COVID-19 may have sustained adverse effects on kidney outcomes, supporting close post-acute renal monitoring and early risk stratification in high-risk patients.
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