Introduction: This article describes the main differences between COVID-19-induced acute kidney injury (AKI-COVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKI-CKD) treated in a high complexity clinic in Barranquilla (Colombia). Material and Methods: The patients included in this study (n: 572) were those with a positive diagnosis of COVID-19 confirmed by detection of a positive PCR for SARS-CoV-2. Of these patients, 188 developed AKI during their hospital stay. Patients’ epidemiological data, serum parameters, and clinical frailty status were recorded. Statistical analysis and comparison among AKI-NRF, AKI-CKD, and non-AKI patients were performed. Results: The incidence of COVID-19-induced AKI was 33%, with the majority classified as AKIN 1, 16% requiring renal replacement therapy, and AKI-COVID19 mortality of 68%. A significantly higher prevalence of hypertension, cardiac disease, and serum reactive C-protein and lower albumin values in AKI-CKD patients was recorded. Mortality rate, invasive ventilation requirement, and D-dimer levels were significantly higher in AKI-NRF patients: Conclusion: Different clinical patterns between AKI-NRF and AKI-CKD were documented.
Introducción: el síndrome respiratorio agudo severo inducido por coronavirus-2 (SARS-CoV-2) se caracteriza por la instalación de una afectación pulmonar. Sin embargo, existen reportes de afectación renal concomitante, con manifestaciones clínicas como hematuria, proteinuria y daño renal agudo.
Objetivo: presentamos dos casos clínicos de síndrome nefrótico asociado a enfermedad por coronavirus (COVID-19).
Presentación del caso: un paciente presentó evidencia histológica de cambios mínimos y fusión de pedicelos de podocitos en muestras histológicas evaluadas por microscopía electrónica.
Discusión: la proteinuria en COVID-19 puede ser secundaria a lesiones glomerulares y tubulares agudas, con un origen multifactorial: factores hemodinámicos, tormentas de citocinas, infecciones secundarias, nefrotoxicidad inducida por fármacos e infección viral directa de las células del túbulo proximal y podocitos. Esta última podría deberse a una infección directa por el virus debido al mayor tropismo renal de este.
Conclusión: el presente informe presenta dos casos de síndrome nefrótico secundario a podocitopatía en pacientes con infección aguda por COVID-19.
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