INFLAMMATION-DRIVEN PAIN IN CHRONIC KIDNEY DISEASE AFTER COVID-19: A CLINICO-BIOLOGICAL CORRELATION STUDY

T. Razlog¹, E. Russu², C. Groza¹, L. Groppa³ | ¹Timofei Mosneaga Republican Clinical Hospital, Chisinau, Republic of Moldova; ²Nicolae Testemitanu State Medical and Pharmaceutical University; Timofei Mosneaga Republican Clinical Hospital, Chisinau, Republic of Moldova; ³Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova

Abstract

Background and Aims. Chronic kidney disease (CKD) is associated with persistent pain, fatigue, and reduced quality of life. In the post-coronavirus disease 2019 (COVID-19) setting, residual inflammation may amplify nociceptive signaling and symptom burden. This study aimed to evaluate the relationship between systemic inflammation and pain expression in CKD patients after COVID-19.
Methods. A comparative cohort study included 280 CKD patients (140 post-COVID, 140 non-COVID controls). Pain was assessed using the visual analog scale and clinical evaluation of lumbar pain. Functional status was measured using the Short Form-36 Health Survey. Biological parameters included C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, hemoglobin, and estimated glomerular filtration rate. Statistical analysis included Spearman correlation, subgroup comparisons, and multivariate regression.
Results. Pain intensity was comparable between groups; however, post-COVID patients demonstrated a stronger inflammation-pain relationship. CRP correlated positively with lumbar pain severity (r=0.22, p=0.007), while ESR correlated inversely with hemoglobin (r=-0.45, p<0.001). Patients with CRP >10 mg/L showed significantly higher pain scores (6.2±1.1 vs 5.1±1.3; p=0.002) and lower vitality scores (44.1±16.9 vs 56.5±19.0; p>0.1).
Conclusions. Pain in CKD patients after COVID-19 is predominantly inflammation-driven rather than related to renal dysfunction. Targeting inflammation and anemia may improve symptom control and functional outcomes.