Acute kidney injury in COVID-19; a review on current knowledge

Aleebrahim-Dehkordi, Elahe; Reyhanian, Ali; Saberianpour, Shirin; Hasanpour-Dehkordi, Ali

doi:10.34172/jnp.2020.31

Cited by 25 publications

(23 citation statements)

References 71 publications

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“…The underlying mechanisms remain unknown. The design of the current study did not allow us to formally distinguish acute tubular necrosis (ATN) caused by a septic condition before D0 or admission to hospital, or low-oxygen delivery to tissues from specific cytopathic lesions caused by SARS-CoV-2 itself [ 17 ]. Some preliminary results with kidney biopsies (including electronic microscopy) suggest direct virus-mediated tubular injury [ 18 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cheng et al [ 2 ] also found an association between kidney involvement, including proteinuria (by dipstick), and in-hospital death. Once again, the design of our study only allows to generate hypotheses to explain the higher mortality rate in patients with abnormal proteinuria (higher viral load and early multiple organ involvement [ 17 , 29 ] or marker of ATN and/or AKI). Association is not causation, and the main cause of death in COVID-19 was respiratory failure, not kidney injury.…”

Section: Discussionmentioning

confidence: 99%

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Proteinuria in COVID-19: prevalence, characterization and prognostic role

et al. 2021

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Background Proteinuria has been commonly reported in patients with COVID-19. However, only dipstick tests have been frequently used thus far. Here, the quantification and characterization of proteinuria were investigated and their association with mortality was assessed. Methods This retrospective, observational, single center study included 153 patients, hospitalized with COVID-19 between March 28th and April 30th, 2020, in whom total proteinuria and urinary α1-microglobulin (a marker of tubular injury) were measured. Association with mortality was evaluated, with a follow-up until May 7th, 2020. Results According to the Kidney Disease Improving Global Outcomes staging, 14% (n = 21) of the patients had category 1 proteinuria (< 150 mg/g of urine creatinine), 42% (n = 64) had category 2 (between 150 and 500 mg/g) and 44% (n = 68) had category 3 proteinuria (over 500 mg/g). Urine α1-microglobulin concentration was higher than 15 mg/g in 89% of patients. After a median follow-up of 27 [14;30] days, the mortality rate reached 18%. Total proteinuria and urinary α1-microglobulin were associated with mortality in unadjusted and adjusted models. This association was stronger in subgroups of patients with normal renal function and without a urinary catheter. Conclusions Proteinuria is frequent in patients with COVID-19. Its characterization suggests a tubular origin, with increased urinary α1-microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Proteinuria in COVID-19: prevalence, characterization and prognostic role

et al. 2021

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“…Therefore, amidst the COVID-19 pandemic, which is already taking a toll on global health, early diagnosis and identification of the underlying etiology are essential to guide proper management. Appropriate infectious control, intravenous fluid management, and respiratory failure management can contribute to preventing further AKIs (2,(7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and acute kidney injury; a case report

et al. 2020

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Although there is no definitive evidence that coronavirus disease 2019 (COVID-19) affects the kidneys adversely, amongst those who develop severe COVID-19 infection and require hospitalization, acute kidney injury (AKI) was reported. Here, we report the clinical outcome associated with AKI in a 32-year-old man with confirmed COVID-19 infection with no prior history of renal malfunction. The AKI was identified during intensive care unit (ICU) course with the median creatinine and blood urea nitrogen values of 3.1 mg/dL (normal value: 0.6-1.2 mg/dL) and 145 mg/dL (normal value:15-45 mg/dL), respectively. Renal function of patients hospitalized with COVID-19 infection needs to be monitored regularly to intervene as early as possible and to prevent the development of AKI and further kidney complications.

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“…The 2019 novel coronavirus enters human cells by binding its spike to the angiotensin-converting enzyme 2 (ACE2) receptor. Proximal tubular cells and podocytes express the ACE2 receptor, resulting in AKI by virus-induced cytopathic effect, which is manifested by hematuria, proteinuria, elevated levels of blood urea nitrogen (BUN), and serum creatinine [2]. In our case-series, AKI was de ned according to kidney disease improving global outcomes (KDIGO) guideline [9].…”

Section: Discussionmentioning

confidence: 99%

“…There are several mechanisms leading to kidney injury in patients with COVID-19 including cytokine storm syndrome, rhabdomyolysis, hypoxia, and dehydration due to fever or decreased intake of uids. In addition, direct virus invasion to the renal tubular cells may contribute to kidney injury [2].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 progression in kidney transplant recipients: A single-center case series

Rahimzadeh

Keykhaei

Razeghi

et al. 2020

Preprint

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The novel coronavirus disease 2019 (COVID-19) is a respiratory infection that has received much attention due to its rapid expansion. Currently, it has been revealed that patients with underlying disease, especially those with kidney disease are more prone to develop complications. Some studies associate kidney transplantation as a risk factor for COVID-19 progression; however, epidemiologic data that demonstrate this are amazingly rare. Considering the importance of the topic, we report on six kidney transplant recipients (median age 47 [41-55]) with confirmed or clinically suspected COVID-19. The most common admission presentations were fever (83.3%), dyspnea, and myalgia. At baseline, immunosuppressive therapy was ceased, prednisolone dose was increased, and all patients received antiviral treatment including hydroxychloroquine and umifenovir. After a median follow-up of 11.5 days from admission, six patients (100%) developed acute kidney injury (AKI), 50% required intensive care unit (ICU) admission, and two patients (33.3%) deceased as a result of deterioration in respiratory status. Overall, these findings demonstrate that AKI development and respiratory involvement may be risk indicators of in-hospital mortality in kidney recipients with COVID-19. Therefore, more intensive attention should be paid to kidney transplant recipients with COVID-19.

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Acute kidney injury in COVID-19; a review on current knowledge

Cited by 25 publications

References 71 publications

Proteinuria in COVID-19: prevalence, characterization and prognostic role

Proteinuria in COVID-19: prevalence, characterization and prognostic role

COVID-19 and acute kidney injury; a case report

COVID-19 progression in kidney transplant recipients: A single-center case series

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