# Effect of Covid-19 on chronic kidney disease progression

> **NIH NIH R03** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $126,000

## Abstract

Project Summary
Coronavirus disease 2019 (COVID-19) is a respiratory illness that has sickened over 7 million people
worldwide and continues to rapidly spread. The causal virus, severe acute respiratory coronavirus 2 (SARS-
CoV-2), targets the kidney, and acute kidney injury is a common complication, affecting 20-40% of hospitalized
patients. Kidney biopsies and autopsies show a unique pathogenesis including acute tubular injury with
significant numbers demonstrating prominent vascular endothelial injury and microthrombi. Although high rates
of acute kidney injury have been described, we currently have no data on the medium to long-term effects of
COVID-19 on kidney function. Patients with underlying chronic kidney disease (CKD) are most vulnerable to
kidney injury, and a subset may experience rapid CKD progression after COVID-19. Endothelial injury, which is
a key feature of severe COVID-19 found on biopsies and autopsies of multiple affected organs, may be more
severe and irreversible in patients who already have kidney diseases that affect the microvasculature. CKD is
one of the most common comorbidities among patients with COVID-19, which has currently affected
approximately 5% of the US population. Accelerated CKD progression in a large number of patients with
preexisting illness who survive COVID-19 will have a substantial adverse effect on patients’ quality of life,
increase morbidity and mortality, and will be a large burden to the US healthcare system. Therefore, there is a
pressing need to understand how COVID-19 affects eGFR decline, predictors of CKD progression, and
underlying mechanisms driving CKD progression after COVID-19. In Aim 1, we will evaluate the association of
COVID-19 with changes in estimated glomerular filtration rate (eGFR) and determine clinical predictors that are
associated with rapid eGFR decline (defined by > 25% loss of eGFR or need for renal replacement therapy
lasting more than 90 days) occurring within 1 year after diagnosis of COVID-19. Elucidation of these risk
factors will allow us to identify patients who are at high risk of progressive CKD after COVID-19. This proposal
benefits from collaboration with the Massachusetts Center for Pathogen Research, allowing us access to
human blood samples from an ongoing biobank of patients with COVID-19 that is enrolling across multiple
sites in Massachusetts. In Aim 2, we will determine 1-year kidney function outcomes in the patients enrolled in
this biobank and perform a case-control study to determine if patients who experience rapid eGFR decline
within 1 year after infection have increased markers of endothelial activation and blood coagulation at the time
of COVID-19 compared to those with stable kidney function. The larger goal of this proposal is to build
preliminary data in preparation for an R01 application over the next 12-24 months to study mechanisms of
CKD progression in patients with COVID-19. Ultimately, we hope to improve our understanding of COVID-19’s...

## Key facts

- **NIH application ID:** 10194834
- **Project number:** 1R03DK128533-01
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Meghan E. Sise
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $126,000
- **Award type:** 1
- **Project period:** 2021-02-04 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10194834

## Citation

> US National Institutes of Health, RePORTER application 10194834, Effect of Covid-19 on chronic kidney disease progression (1R03DK128533-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10194834. Licensed CC0.

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