Nikhil Prasad Fact checked by:Thailand Medical News Team Aug 19, 2026 59 minutes ago
A new medical review is drawing attention to the wide range of kidney problems reported after SARS-CoV-2 infection and, much less commonly, following COVID-19 vaccination. Importantly, the researchers found that COVID-19 infection poses a substantially greater threat to the kidneys than vaccination, while stressing that unusual kidney reactions reported after vaccination still deserve careful medical attention.
COVID-19 infection carries a much greater acute kidney injury risk than vaccination, although uncommon kidney
disorders have also been reported following vaccination
Researchers Examine Two Different Kidney Risks
The commentary was written by Naya Williams and Mohammed S. Razzaque. The researchers are from the Department of Medical Education, School of Medicine, University of Texas Rio Grande Valley, Edinburg, Texas, USA, and the Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Malaysia.
The authors reviewed human studies identified through PubMed covering January 2020 through December 2024, examining kidney damage associated with COVID-19 infection and reported kidney problems following vaccination.
COVID-19 Can Seriously Damage the Kidneys
The findings show that SARS-CoV-2 can harm kidneys through several pathways. Severe infection can produce intense inflammation, disturb blood circulation, damage blood-vessel linings and promote tiny blood clots. The virus may also interact with ACE2 receptors found on several types of kidney cells.
Acute kidney injury, or AKI, is particularly important. In one study involving 3,993 hospitalized COVID-19 patients, 1,835 developed AKI. Among those affected, 347 required dialysis. Even more concerning, hospital mortality reached 50 percent among COVID-19 patients with AKI, compared with 8 percent among those without AKI.
Genetics may also influence vulnerability. Among 990 hospitalized veterans of African ancestry, 12.6 percent carried high-risk APOL1 genetic variants. Of those carrying these variants, 51.2 percent developed AKI and 19.2 percent died.
Kidney Disorders Reported After Vaccination
Meanwhile, this Thailand
Medical News report highlights that kidney complications reported following COVID-19 vaccination are relatively uncommon and appear mainly related to immune activation rather than direct damage from vaccine components.
Reported conditions include minimal change disease, IgA nephropathy, ANCA-associated vasculitis, acute interstitial nephritis, membranous nephropathy, FSGS and other inflammatory kidney disorders. An analysis cited by the authors found that 69 percent of 130 reported cases represented newly developed kidney disease, while 31 percent were relapses of existing disease.
Crucially, timing does not prove that vaccination caused these conditions. Kidney biopsy can identify the type of damage but cannot definitively establish vaccine causation. The overall clinical picture, timing and exclusion of alternative causes must therefore be considered.
Infection Carries the Greater Risk
One of the most important findings is that the absolute risk of AKI is substantially lower after COVID-19 vaccination than following SARS-CoV-2 infection. After adjustment for possible confounding factors, infection was associated with an approximately tenfold higher risk of AKI compared with vaccination.
Conclusions
The review shows that kidney injury associated with COVID-19 can be serious, complex and potentially life-threatening, while post-vaccination kidney disorders appear considerably less frequent. Nevertheless, people with existing kidney disease, transplant recipients and other vulnerable individuals may benefit from careful monitoring and prompt investigation of unusual urinary or kidney-related symptoms.
The study findings were published in the peer reviewed Journal of Molecular Pathology.
https://www.mdpi.com/2673-5261/7/3/28
Read Also:
https://www.thailandmedical.news/articles/coronavirus
https://www.thailandmedical.news/articles/long-covid
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