A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results (original) (raw)
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International Journal of Molecular Sciences
The continually evolving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in a vast number of either acute or chronic medical impairments of a pathophysiology that is not yet fully understood. SARS-CoV-2 tropism for the organs is associated with bilateral organ cross-talks as well as targeted dysfunctions, among which acute kidney injury (AKI) seems to be highly prevalent in infected patients. The need for efficient management of COVID-related AKI patients is an aspect that is still being investigated by nephrologists; however, another reason for concern is a disturbingly high proportion of various types of kidney dysfunctions in patients who have recovered from COVID-19. Even though the clinical picture of AKI and COVID-related AKI seems to be quite similar, it must be considered that regarding the latter, little is known about both the optimal management and long-term consequences. These discrepancies raise an urgent need for further research aime...
Acute kidney injury in COVID 19 – an update on pathophysiology and management modalities
Archives of Physiology and Biochemistry
Acute kidney injury (AKI), characterised by fluid imbalance and overload, is prevalent in severe disease phenotypes of coronavirus disease 2019 (COVID-19). The elderly immunocompromised patients with pre-existing comorbidities being more risk-prone to severe COVID-19, the importance of early diagnosis and intervention in AKI is imperative. Histopathological examination of COVID-19 patients with AKI reveals viral invasion of the renal parenchyma and evidence of AKI. The definitive treatment for AKI includes renal replacement therapy and renal transplant. Immunosuppressant regimens and its interactions with COVID-19 have to be further explored to devise effective treatment strategies in COVID-19 transplant patients. Other supportive strategies for AKI patients include hemodynamic monitoring and maintenance of fluid balance. Antiviral drugs should be meticulously monitored in the management of these high-risk patients. We have focussed on the development of renal injury provoked by the SARS-CoV-2, the varying clinical characteristics, and employment of different management strategies, including renal replacement therapy, alongside the emerging cytokine lowering approaches.
Acute Kidney injury and COVID-19 infection
International Journal of Clinical Images and Medical Reviews
COVID-19 infection is currently one of the most discussed medical and socioeconomic issues. Generally, it manifests as pneumonia. However, there is a growing body of evidence of multi-organ damage. Manifestations of kidney involvement associated with infection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus include proteinuria, hematuria, and acute kidney injury (AKI). The presence of AKI negatively affects the prognosis and mortality rate of this infection. The pathogenesis of AKI associated with COVID-19 infection is complex and include the direct and indirect mechanism of renal damage by the virus. Identifying risk factors for AKI development associated with COVID-19 can contribute to improved management as well as patient prognosis.
Recent Evidence on Acute Kidney Injury in COVID-19 Patients: A Narrative Review
Bioscientia Medicina : Journal of Biomedicine and Translational Research
The pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The clinical manifestation of COVID-19 is broad, ranging from an asymptomatic carrier state to severe disease leading to the death penalty. There is also emerging evidence that kidneys are affected early in COVID-19. Proteinuria and haematuria have been reported in 44% and 26.7% on admission, respectively. This literature review shows clinical manifestations of acute kidney injury (AKI) in a patient with COVID-19 infection. Literature reviews are carried out on various sources found on Google Scholar and Pubmed to search for articles, journal research, case reports, systematic reviews, meta-analyses, and textbooks. Various studies demonstrate the possibility of coronavirus infecting the kidney with several mechanisms such as cytokine storm syndrome (CSS), direct viral infection, and imbalance of renin-angiotensin-aldosterone (RAAS). Haematuria and protein...
Acute Kidney Injury in COVID-19: a Brief Review
Indian Journal of Surgery, 2021
The contemporary evolution of the coronavirus disease 2019 (COVID-19) outbreak from the Wuhan, China, with a high rate of transmission will act the global medical emergency with immense morbidity and mortality rate across the world. The cell entry of COVID-19 via angiotensin-converting enzyme 2 receptor (ACE-2 receptor) will damage the respiratory system by the cytopathic effect induced by replication of the virus genome in the host and respond respiratory failure with an elevation of cytokine factorlike interleukin (IL) IL-6, IL-8, tumor necrosis factor-alpha (TNF-alpha), etc. However, the lung-kidney cross talk will evidence the activation of molecular mechanisms from pro-inflammatory cytokines and concerned with kidney damage, though the elevated rate of ACE-2 receptor in the kidney will enhance the possibility of mortality with consideration of acute kidney injury. This review provides relevant information which suggests the rate of mortality in COVID-19 patient associated with acute kidney injury (AKI) which lacks critical monitoring of kidney function with a clinical consideration of intervention to avoid kidney damage in the initial stage of the disease.
Post-COVID–19 complication and its effect on acute kidney injury
Journal of Renal Endocrinology, 2021
The novel coronavirus outbreak has become a global health emergency. The common symptoms of COVID-19 disease which have affected a large population are common cold, fatigue, headache and fever. However, complications such as multiple organ failure, acute respiratory syndrome and septic shock are seen in about 5% of patients with persisting severe symptoms and post-COVID syndrome. The COVID-19 acute kidney injury in patients displays damage in the kidney, proteinuria, hematuria and elevated serum creatinine. The symptoms of acute kidney injury vary from mild to severe, which necessitates proper clinical management and renal replacement therapy (RRT). Therefore, it is necessary to understand the pathophysiology of acute kidney injury involving infiltrated immune cells, thrombosis, and cytokine regulation. There is no definite treatment for acute kidney injury; the strategy for preventing the complications will only come through clinical experience. Therefore, more studies are needed f...
The etiology and pathophysiology of COVID-19 associated acute kidney injury
Romanian Medical Journal
Hospitalized COVID-19 patients often develop acute kidney injury (AKI), leading to increased mortality. In order to improve patients’ survival rate, it is important to understand the pathophysiology mechanism of AKI. In this brief review, we highlight the most important elements of the etiology and pathophysiology of COVID-19 associated AKI. Acute tubular injury seems to be more frequent than prerenal azotemia in COVID-19 patients and collapsing glomerulopathy is the most encountered form of glomerular disease. Another important role in acute kidney injury seems to play immune cell infiltration, inflammation, endothelial injury and microvascular thrombi. Renin-angiotensin-aldosterone system is also important in the pathophysiology of COVID-19 associated AKI.
Acute kidney injury in COVID-19; a review on current knowledge
Journal of Nephropathology
Coronaviruses are a large family of viruses that can cause a variety of diseases in humans. Some coronaviruses cause only mild illnesses like the common cold. While, some coronaviruses such as SARS-CoV (SARS-associated coronavirus) and Middle East respiratory syndrome coronavirus (MERS-CoV) have, in recent years, been able to cause severe respiratory involvement (pneumonia), leading to death in several patients. By identifying the genomic sequence of the new human coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) it has been revealed that it belongs to the beta coronavirus genus. COVID-19 appears to be transmitted by a mechanism similar to the influenza virus via person to person, sneezing coughing, or contact with the secretions of infected patients. Early symptoms of these respiratory viruses include fever, cough, and shortness of breath, with an incubation period of 2-14 days. SARS-CoV-2 is an acute respiratory disease that initially causes lung damage. SAR...
Acute kidney injury associated with COVID-19: understanding its underlying mechanism
Applied Science and Technology Annals, 2020
World Health Organization (WHO) has declared coronavirus disease 2019 (COVID-19) outbreak as a global emergency. Kidney involvement is commonly seen in COVID-19 patients with clinical findings ranging from mild proteinuria to acute kidney injury (AKI) in hospitalized patients. In this viewpoint, I would like to discuss about various mechanism contributing to AKI such as, entry of novel coronavirus into host cell, cytokine storm that destroy kidney tissues, increased blood clotting that clogs kidney, and probable direct infection of the kidney.
Journal of the College of Physicians and Surgeons Pakistan, 2020
Acute kidney injury (AKI) is relatively common in critically ill coronavirus disease 2019 (COVID-19) patients and it increases mortality and prolongs hospital stay. This article aimed to investigate the history, virology, epidemiology, clinical manifestations, pathophysiology and management of COVID-19 disease, in general, and the pathogenetic mechanisms of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV2)-induced kidney damage, in particular. Keywords like SARS-CoV2, COVID-19, renal impairment, sepsis, viremia, etc. were used to find relevant publications from PubMed, Scopus, Google Scholar, and clinical trials registry websites. According to different studies, kidney involvement in COVID-19 typically occurs in patients who develop acute respiratory distress syndrome (ARDS) or multiorgan failure. The kidney damage in COVID-19 has been shown to be multifactorial, involving direct viral infection, indirect injury by sepsis, hemodynamic alterations, cytokine storm, disseminated intravascular coagulation and other unknown mechanisms. The presence in kidney of angiotensin-converting enzyme 2 (ACE2), a receptor for the virus, has been proven, but few cases of direct viral presence in kidney tissue have been published. Therefore, further studies are needed to investigate the exact mechanisms underlying kidney impairment. Since the development of AKI is one of the important risk factors for mortality in COVID-19 patients, optimal management of AKI may improve the outcomes.