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Long COVID and the kidney

Vanja Ivković1, Urmila Anandh2, Samira Bell3

  • 1Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. vanja.ivkovic@gmail.com.

Nature Reviews. Nephrology
|September 4, 2025
PubMed

Insights

Long COVID, a persistent condition after SARS-CoV-2 infection, can lead to chronic kidney disease (CKD). Vaccination against SARS-CoV-2 is crucial for preventing severe COVID-19 and long COVID, especially in CKD patients.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Long coronavirus disease (COVID) is a complex condition affecting multiple organ systems, including the kidneys, persisting for over three months post-SARS-CoV-2 infection.
  • COVID-19 is linked to acute kidney injury and an increased risk of chronic kidney disease (CKD), suggesting CKD as a potential manifestation of long COVID.
  • Patients with pre-existing CKD face higher risks of severe COVID-19 and developing long COVID.

Purpose of the Study:

  • To explore the multifaceted impact of COVID-19 on kidney health, including the development and progression of chronic kidney disease.
  • To highlight the bidirectional relationship between COVID-19, long COVID, and chronic kidney disease.
  • To emphasize the role of SARS-CoV-2 vaccination in mitigating risks associated with COVID-19 and long COVID, particularly for vulnerable CKD populations.

Main Methods:

  • Review of existing literature and studies investigating the renal manifestations of COVID-19 and long COVID.
  • Analysis of reported associations between SARS-CoV-2 infection and kidney diseases, including COVID-19-associated nephropathy and vasculitis.
  • Evaluation of the impact of SARS-CoV-2 vaccination on COVID-19 and long COVID incidence in the general population and CKD patients.

Main Results:

  • COVID-19 can cause acute kidney injury and is associated with an increased risk of developing chronic kidney disease (CKD).
  • Specific kidney conditions like collapsing glomerulopathy and new-onset vasculitis have been linked to COVID-19.
  • SARS-CoV-2 vaccination significantly reduces the risk of COVID-19 and long COVID, offering protection to all individuals, especially those with CKD.

Conclusions:

  • Chronic kidney disease (CKD) can be a significant sequela of long COVID, necessitating ongoing research and monitoring.
  • The interplay between COVID-19 and CKD underscores the importance of comprehensive care for affected patients.
  • Structured follow-up for COVID-19 survivors is essential to understand long COVID trajectories and identify individuals at risk for CKD.

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