The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected patients with kidney disease, causing significant challenges in disease management, kidney research and trainee education. For patients, increased infection risk and disease severity, often complicated by acute kidney injury, have contributed to high mortality. Clinicians were faced with high clinical demands, resource shortages and novel ethical dilemmas in providing patient care. In this review, we address the impact of COVID-19 on the entire spectrum of kidney care, including acute kidney injury, chronic kidney disease, dialysis and transplantation, trainee education, disparities in health care, changes in health care policies, moral distress and the patient perspective. Based on current evidence, we provide a framework for the management and support of patients with kidney disease, infection mitigation strategies, resource allocation and support systems for the nephrology workforce.

Associate Scientist Renal Division Brigham and Women's Hospital Harvard Medical School Boston USA

Cincinnati Children's Hospital Medical Center and University of Cincinnati Cincinnati Ohio USA

Consultant Nephrologist and Professor in the Department of Clinical Medicine Faculty of Medicine University of Colombo Colombo Sri Lanka

Deming Department of Medicine Tulane University School of Medicine New Orleans Louisiana USA

Department of Internal Medicine Keck School of Medicine of University of Southern California Los Angeles California USA

Department of Lifespan and Population Health University of Nottingham Nottingham UK

Department of Medicine Division of Nephrology Johns Hopkins University School of Medicine Baltimore Maryland USA

Department of Medicine Division of Nephrology Stanford University School of Medicine Standford California USA

Department of Medicine Kwame Nkrumah University of Science and Technology Kumasi Ghana

Department of Medicine University of Cambridge Cambridge UK

Department of Nephrology and Palliative Care St Vincent's Hospital Melbourne Australia and Department of Medicine University of Melbourne Parkville Australia

Department of Nephrology Charles University Prague Czech Republic

Department of Nephrology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

Department of Nephrology Seth Gordhandas Sunderdas Medical College Hospital Mumbai India

Department of Paediatrics University of Cincinnati School of Medicine Cincinnati Ohio USA

Department of Renal Medicine Eastern Health Clinical School Monash University Melbourne Australia

Department of Research The Danish Heart Foundation Copenhagen Denmark

Department of Visceral Transplant and Thoracic Surgery Center of Operative Medicine Medical University of Innsbruck Innsbruck Austria

Division of Nephrology and Hypertension Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

Division of Nephrology and Hypertension Nationwide Children's Hospital and Department of Paediatrics The Ohio State University College of Medicine Columbus Ohio USA

Division of Nephrology Department of Medicine Vagelos College of Physicians and Surgeons and the Department of Epidemiology Mailman School of Public Health Columbia University New York USA

Faculty of Medicine Universiti Teknologi MARA Selangor Malaysia

George Institute for Global Health New Delhi India

Honorary Associate Professor Department of Paediatrics and Child Health University of Cape Town Cape Town South Africa

James M Anderson Center for Health Systems Excellence Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

Leonard D Schaeffer Center for Health Policy and Economics University of Southern California Los Angeles California USA

Nephrologist University Childrens Hospital Zurich Switzerland

Prasanna School of Public Health Manipal Academy of Higher Education Manipal India

Principal Voice of the Patient Inc St Louis Missouri USA

Renal Unit Komfo Anokye Teaching Hospital Kumasi Ghana

School of Public Health Imperial College London UK

University Medical Unit National Hospital of Sri Lanka and National Institute of Nephrology Dialysis and Transplantation Colombo Sri Lanka

Erratum v

Nat Rev Nephrol. 2022 Nov;18(11):738. doi: 10.1038/s41581-022-00635-3. PubMed

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