Renal Long COVID: A Scoping Review.

Abstract

Rationale & objective: Whether long coronavirus disease (long COVID) affects the kidneys remains to be understood. In this scoping review, we described the evidence of renal long COVID.

Study design: A scoping review was conducted according to the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines by searching MEDLINE, Embase, and other databases from inception until February 2025.

Setting & study populations: We included evidence on kidney-related outcomes in adult survivors of coronavirus disease 2019 (COVID-19) with data on long COVID.

Selection criteria for studies: Cohorts from all settings.

Data extraction: We extracted data related to longitudinal kidney outcomes.

Analytical approach: Data were synthesized and presented in tables and figures.

Results: We screened 6,203 studies and included 37 in this review (38 reports), comprising 1,308,265 individuals with follow-up data. The majority were retrospective (61%) and from Europe (37%). All reports included hospitalized patients and 34% also included the community setting. Acute kidney injury (AKI) during acute COVID-19 phase was assessed in 58% of the reports. Chronic kidney disease (CKD) development was assessed in 29% of the reports, with wide variation in its frequency, ranging from 0.4%-45%. Progression of CKD (7 studies, 18%) ranged from 8%-49%. Studies reporting higher frequencies of AKI found larger rates of renal long COVID. Overall, there was high heterogeneity in how kidney-related outcomes were reported during follow-up. Most studies presented data on crude kidney function biomarkers (eg, serum creatinine or estimated glomerular filtration rate), while a few (13%) reported major adverse kidney events. Data on proteinuria or urinary biomarkers were scarce.

Limitations: Lack of studies with pre-COVID-19 data.

Conclusions: This scoping review highlighted that renal long COVID, characterized by CKD development and/or progression, may occur. Available evidence suggests that AKI may be associated with renal long COVID. Therefore, long-term kidney function monitoring is advisable after COVID-19 recovery to enable early diagnosis and timely intervention for CKD.