Acute Renal Failure in Critically Ill COVID-19 Patients With a Focus on the Role of Renal Replacement Therapy: A Review of What We Know So Far

Raza, Ahmad; Estepa, Adrian; Chan, Vincent; Jafar, Munnam

doi:10.7759/cureus.8429

Cited by 38 publications

(38 citation statements)

References 44 publications

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“…SARS-CoV-2 not only induces the diffused alveolar injury and acute respiratory failure, but also involves other organs, such as kidney and leads to renal resident cells injury (Huang et al 2020 ). AKI is a common feature of renal disease, occurred in 5–15% of patients with SARS- and MERS-CoV infection with higher rate of mortality (Raza et al 2020 ) In the first reports, the AKI incidence was few among COVID-19 patients. However, recent studies confirmed kidney failure in SARS COV2, related to the hospital death of cases with severe COVID-19 (Cheng et al 2020a ; Wang et al 2020d ).…”

Section: Covid- 19 and Renal Diseasesmentioning

confidence: 99%

COVID-19 and multiorgan failure: A narrative review on potential mechanisms

et al. 2020

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The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in December 2019 form Wuhan, China leads to coronavirus disease 2019 (COVID-19) pandemic. While the common cold symptoms are observed in mild cases, COVID-19 is accompanied by multiorgan failure in severe patients. The involvement of different organs in severe patients results in lengthening the hospitalization duration and increasing the mortality rate. In this review, we aimed to investigate the involvement of different organs in COVID-19 patients, particularly in severe cases. Also, we tried to define the potential underlying mechanisms of SARS-CoV2 induced multiorgan failure. The multi-organ dysfunction is characterized by acute lung failure, acute liver failure, acute kidney injury, cardiovascular disease, and as well as a wide spectrum of hematological abnormalities and neurological disorders. The most important mechanisms are related to the direct and indirect pathogenic features of SARS-CoV2. Although the presence of angiotensin-converting enzyme 2, a receptor of SARS-CoV2 in the lung, heart, kidney, testis, liver, lymphocytes, and nervous system was confirmed, there are controversial findings to about the observation of SARS-CoV2 RNA in these organs. Moreover, the organ failure may be induced by the cytokine storm, a result of increased levels of inflammatory mediators, endothelial dysfunction, coagulation abnormalities, and infiltration of inflammatory cells into the organs. Therefore, further investigations are needed to detect the exact mechanisms of pathogenesis. Since the involvement of several organs in COVID-19 patients is important for clinicians, increasing their knowledge may help to improve the outcomes and decrease the rate of mortality and morbidity.

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Section: Covid- 19 and Renal Diseasesmentioning

confidence: 99%

COVID-19 and multiorgan failure: A narrative review on potential mechanisms

et al. 2020

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“…High creatinine levels were detected in individuals with severe cases of COVID-19 who were transitioning to multi-organ failure (28). Elevated creatinine serum levels are often corollary to comorbid diseases including diabetes, cancer, chronic renal failure, and some viruses, which can eventually lead to acute kidney injury (AKI) in severely ill and hospitalized patients, including COVID-19 patients (29,30). The development of AKI in patients with comorbidities is positively correlated with increased mortality.…”

Section: Gender Differences In Comorbidities and The Link To Creatininementioning

confidence: 99%

Molecular and Biological Mechanisms Underlying Gender Differences in COVID-19 Severity and Mortality

et al. 2021

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Globally, over two million people have perished due to the recent pandemic caused by SARS-CoV-2. The available epidemiological global data for SARS-CoV-2 portrays a higher rate of severity and mortality in males. Analyzing gender differences in the host mechanisms involved in SARS-CoV-2 infection and progression may offer insight into the more detrimental disease prognosis and clinical outcome in males. Therefore, we outline sexual dimorphisms which exist in particular host factors and elaborate on how they may contribute to the pronounced severity in male COVID-19 patients. This includes disparities detected in comorbidities, the ACE2 receptor, renin-angiotensin system (RAS), signaling molecules involved in SARS-CoV-2 replication, proteases which prime viral S protein, the immune response, and behavioral considerations. Moreover, we discuss sexual disparities associated with other viruses and a possible gender-dependent response to SARS-CoV-2 vaccines. By specifically highlighting these immune-endocrine processes as well as behavioral factors that differentially exist between the genders, we aim to offer a better understanding in the variations of SARS-CoV-2 pathogenicity.

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“…Altogether, these results indicate an association of AKI and mortality among COVID-19 patients (Table 2). Although studies showed a low rate of renal replacement therapy for COVID-19 patients with advanced AKI [19], this result explained by the high rate of mortality in advanced renal disease among patients suffering from SARS-CoV-2 infection. By this study, the risk of mortality in COVID-19 patients was strongly related to AKI (S.CR HR 44.23; 95% CI: 16.34, 119.70, p=0.000) and (BUN 13.04% versus 2.28%, HR 5.59, 95% CI: 1.86, 16.84, p=0.020) (Table 5, Fig.…”

Section: Discussionmentioning

confidence: 97%

Acute kidney and liver injury could be the cause of death in patients with COVID-19

Qak¹,

Nassir²,

Ha³

et al. 2021

Preprint

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We evaluated the increase in the risk of developing acute kidney and hepatic injury. Moreover, we investigate the association between kidney and liver biomarkers with poor prognosis and mortality rate. Methods: This was a prospective cohort study of 397 adult patients with an average age of 48.03 ± 14.09 were diagnosed with COVID-19 of whom, 46 (11.59%) died in hospital. The upper values of the kidney and liver biomarkers were obtained from the recovered patients during the disease period and are compared to the data for dead patients at admission (Baseline) and one day before death. Results: At admission to the hospital, the baseline S.Cr, BUN, and eGFR were not significantly varied between recovered and dead patients. Furthermore, the baseline values for AST, ALT, and ALP were not significantly differed between both groups. Whereas, baseline value of total serum bilirubin was higher in died compared to the recovered patients. For dead patients, the day before death, 52.17% of the patients had progressed to stage III and stage IV AKI. S.Cr and BUN were significantly higher, and eGFR was lower compared to the recovered patients. All of the kidney and liver function tests were abnormally increased from baseline to the day before death. The AST, ALT, and total bilirubin one day before death were significantly higher compared to their baseline value. Conclusions: COVID-19 patients have a high risk for the development of AKI and liver injury that can be progressed to a chronic stage and increase the mortality rate.

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Acute Renal Failure in Critically Ill COVID-19 Patients With a Focus on the Role of Renal Replacement Therapy: A Review of What We Know So Far

Cited by 38 publications

References 44 publications

COVID-19 and multiorgan failure: A narrative review on potential mechanisms

COVID-19 and multiorgan failure: A narrative review on potential mechanisms

Molecular and Biological Mechanisms Underlying Gender Differences in COVID-19 Severity and Mortality

Acute kidney and liver injury could be the cause of death in patients with COVID-19

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