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The Dilemma of Renal Involvement in COVID-19: A Systematic Review

Hamza Bajwa1, Yumna Riaz1, Muhammad Ammar2

  • 1Internal Medicine, King Edward Medical University, Mayo Hospital, Lahore, PAK.

Cureus
|July 21, 2020
PubMed

Insights

COVID-19 patients with acute kidney insufficiency face severe illness and high mortality rates. This highlights the critical need for monitoring kidney health in these patients, especially those with pre-existing kidney conditions.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, presents a global health challenge.
  • Older adults and those with comorbidities experience more severe COVID-19 outcomes.
  • Understanding acute kidney injury (AKI) in COVID-19 is vital for explaining severe patient prognoses.

Purpose of the Study:

  • To review the prevalence and mortality rates of acute kidney insufficiency in COVID-19 patients.
  • To analyze the clinical course and outcomes of COVID-19 patients who develop AKI.
  • To emphasize the risks for patients with pre-existing kidney disease.

Main Methods:

  • Literature review including studies on COVID-19 patient prevalence and mortality with AKI.
  • Analysis of data from 1098 COVID-19 positive patients.
  • Focus on identifying specific mortality rates and disease severity in patients with AKI.

Main Results:

  • 66 out of 1098 (6%) COVID-19 patients developed acute kidney insufficiency.
  • A high mortality rate of 94% (62 deaths) was observed in COVID-19 patients with AKI.
  • Patients with AKI experienced more severe disease courses and higher ICU admission rates.

Conclusions:

  • Acute kidney insufficiency is a significant complication of COVID-19, associated with severe outcomes and high mortality.
  • COVID-19 patients with pre-existing kidney disease, including chronic kidney disease and transplant recipients on immunosuppression, require heightened vigilance.
  • Further research into the pathogenesis of AKI in COVID-19 is warranted to improve patient management and outcomes.

Keywords:
acute kidney insufficiencychronic kidney diseasecoronaviruscytokine release syndromedialysisrenal replacement therapy

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