Abstract
BACKGROUND: This study aims to evaluate the impact of COVID-19 on the progression of CKD in non-dialysis patients and its relation to clinical outcomes in Palestine. MATERIALS AND METHODS: We conducted a retrospective cohort study that followed non-dialysis CKD patients receiving treatment at outpatient clinics in governmental hospitals. Out of the 248 CKD patients who met the inclusion criteria, 98 were diagnosed with COVID-19 between March 2020 and March 2022. We collected data at three distinct time intervals, both prior to and after their COVID-19 infection. We examined the decline in eGFR and gathered demographic information, hospitalization, and mortality rates. The drop in eGFR was recorded 15 months from baseline. RESULTS: The mean age of the patients was 55 years, with 55.6% being male. Patients diagnosed with COVID-19 faced a significantly higher risk of rapid deterioration in eGFR, with a 3.7-fold increase compared to those without COVID-19 (ap-value: <0.001; aOR: 3.7; 95% CI: 2.1-6.3). Additionally, COVID-19 patients had 4.4 times higher mortality rates (ap-value: 0.005; aOR: 4.4; 95% CI: 1.6-12.4), 13.3 times higher rates of dialysis initiation within 15 months post-baseline (ap-value: <0.001; aOR: 13.3; 95% CI: 6.1-28.7), and 3.5 times higher rates of hospital admissions (ap-value: <0.001; aOR: 3.5; 95% CI: 1.8-6.7) compared to the COVID-19 negative group. CONCLUSION: CKD patients who contract COVID-19 experience a more rapid decline in kidney function, leading to worse health outcomes, including increased mortality rates, a greater need for dialysis, and higher hospitalization rates.