Over the course of the COVID-19 pandemic, numerous studies have aimed to address the challenges faced by patients with kidney disease and their caregivers. These studies addressed areas of concern such as the high infection and mortality risk of patients on in-centre haemodialysis and transplant recipients. However, the ability to draw meaningful conclusions from these studies has in some instances been challenging, owing to barriers in aspects of usual care, data limitations and problematic methodological practices. In many settings, access to SARS-CoV-2 testing differed substantially between patient groups, whereas the incidence of SARS-CoV-2 infection varied over time and place because of differences in viral prevalence, targeted public health policies and vaccination rates. The absence of baseline kidney function data posed problems in the classification of chronic kidney disease and acute kidney injury in some studies, potentially compromising the generalizability of findings. Study findings also require attentive appraisal in terms of the effects of confounding, collider bias and chance. As this pandemic continues and in the future, the implementation of sustainable and integrated research infrastructure is needed in settings across the world to minimize infection transmission and both prevent and plan for the short-term and long-term complications of infectious diseases. Registries can support the real-world evaluation of vaccines and therapies in patients with advanced kidney disease while enabling monitoring of rare complications.

在 COVID-19 大流行期间，大量研究旨在解决肾病患者及其护理人员面临的挑战。这些研究解决了一些值得关注的领域，例如中心血液透析患者和移植受者的高感染和死亡风险。然而，由于常规护理、数据限制和有问题的方法实践方面的障碍，从这些研究中得出有意义的结论的能力在某些情况下具有挑战性。在许多情况下，不同患者群体之间获得 SARS-CoV-2 检测的机会存在很大差异，而由于病毒流行率、有针对性的公共卫生政策和疫苗接种率的差异，SARS-CoV-2 感染的发病率随时间和地点的不同而变化。在一些研究中，基线肾功能数据的缺乏给慢性肾病和急性肾损伤的分类带来了问题，可能会损害研究结果的普遍性。研究结果还需要仔细评估混杂因素、碰撞偏差和机会的影响。随着这一流行病的持续和未来，世界各地需要实施可持续和综合的研究基础设施，以最大限度地减少感染传播，并预防和规划传染病的短期和长期并发症。注册中心可以支持对晚期肾病患者的疫苗和疗法进行实际评估，同时监测罕见并发症。