Management of Acute Kidney Injury in the Setting of Acute Respiratory Distress Syndrome: Review Focusing on Ventilation and Fluid Management Strategies

Upadhyaya, Vandan; Shariff, Mohammed; Mathew, Roy; Hossain, Mohammad A.; Asif, Arif; Vachharajani, Tushar J.

doi:10.14740/jocmr3938

Cited by 17 publications

(9 citation statements)

References 38 publications

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“…Authors claim that kidney tubular epithelium damage generates a higher expression of IL-6, emphasizing that increased serum levels of this inflammatory biomarker correlates with increased alveolar permeability and inflammation. Also, ARDS may result in kidney medulla hypoxia, enhancing tubular injury 23 , 24 .…”

Section: Integrated Discussionmentioning

confidence: 99%

A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results

et al. 2021

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Acute kidney injury (AKI) in hospitalized patients with COVID-19 is associated with higher mortality and a worse prognosis. Nevertheless, most patients with COVID-19 have mild symptoms, and about 5% can develop more severe symptoms and involve hypovolemia and multiple organ dysfunction syndrome. In a pathophysiological perspective, severe SARS-CoV-2 infection is characterized by numerous dependent pathways triggered by hypercytokinemia, especially IL-6 and TNF-alpha, leading to systemic inflammation, hypercoagulability, and multiple organ dysfunction. Systemic endotheliitis and direct viral tropism to proximal renal tubular cells and podocytes are important pathophysiological mechanisms leading to kidney injury in patients with more critical infection, with a clinical presentation ranging from proteinuria and/or glomerular hematuria to fulminant AKI requiring renal replacement therapies. Glomerulonephritis, rhabdomyolysis, and nephrotoxic drugs are also associated with kidney damage in patients with COVID-19. Thus, AKI and proteinuria are independent risk factors for mortality in patients with SARS-CoV-2 infection. We provide a comprehensive review of the literature emphasizing the impact of acute kidney involvement in the evolutive prognosis and mortality of patients with COVID-19.

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Section: Integrated Discussionmentioning

confidence: 99%

A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results

et al. 2021

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“…Hemodynamic compromise from pulmonary embolism, right ventricular dysfunction, and myocardial injury may contribute [ 46 , 47 ]. The ARDS-AKI axis AKI is the most common extra-pulmonary organ injury in ARDS via mechanisms including hypoxemia, reduced cardiac output, and systemic inflammation [ 48 , 49 ]. Moreover, AKI-induced lung injury may further propagate severity of disease [ 50 ].…”

Section: Main Textmentioning

confidence: 99%

The COVID-19 nephrology compendium: AKI, CKD, ESKD and transplantation

et al. 2020

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The pandemic of coronavirus disease 2019 (CoVID-19) has been an unprecedented period. The disease afflicts multiple organ systems, with acute kidney injury (AKI) a major complication in seriously ill patients. The incidence of AKI in patients with CoVID-19 is variable across numerous international studies, but the high incidence of AKI and its associated worse outcomes in the critical care setting are a consistent finding. A multitude of patterns and mechanisms of AKI have been elucidated, and novel strategies to address shortage of renal replacement therapy equipment have been implemented. The disease also has had consequences on longitudinal management of patients with chronic kidney disease and end stage kidney disease. Kidney transplant recipients may be especially susceptible to CoVID-19 as a result of immunosuppression, with preliminary studies demonstrating high mortality rates. Increased surveillance of disease with low threshold for testing and adjustment of immunosuppression regimen during acute periods of illness have been recommended.

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“…Otherwise, particularly if the kidney function is impaired or the airway pressure used are such that the hormonal response is fully shifted towards sodium and water reabsorption, renal replacement therapy should be considered. Indications and limits of this approach have been recently reviewed [59].…”

Section: Origin Of Positive Fluid Balance and Modality Of Correctionmentioning

confidence: 99%

Fluid administration and monitoring in ARDS: which management?

et al. 2020

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Management of Acute Kidney Injury in the Setting of Acute Respiratory Distress Syndrome: Review Focusing on Ventilation and Fluid Management Strategies

Cited by 17 publications

References 38 publications

A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results

A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results

The COVID-19 nephrology compendium: AKI, CKD, ESKD and transplantation

Fluid administration and monitoring in ARDS: which management?

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