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Kidney disease and electrolytes in COVID-19: more than meets the eye
Sol Carriazo1, Mehmet Kanbay2, Alberto Ortiz1
1IIS-Fundación Jiménez Diaz UAM and School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain.
Insights
This review covers the global impact of COVID-19 on kidney disease, highlighting acute kidney injury and cardiorenal syndromes. It discusses dialysis options, risks for chronic kidney disease patients, and emerging therapies.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- COVID-19 pandemic significantly impacts global health, with government actions influencing its spread.
- Kidney disease is a major complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
- The Clinical Kidney Journal issue compiles research from three continents on COVID-19's renal manifestations.
Discussion:
- Clinical presentations include SIADH, AKI, CKD, collapsing glomerulopathy, and thrombotic microangiopathy.
- Acute kidney injury management challenges, including hemodialysis (HD) and hemofiltration capacity.
- Acute peritoneal dialysis (PD) as a critical life-saving intervention.
Key Insights:
- Pre-existing chronic kidney disease (CKD) elevates COVID-19 complication risk.
- Impact of COVID-19 on patients undergoing PD and HD, with emphasis on prevention.
- Review of current and investigational therapies, including complement inhibition (eculizumab).
Outlook:
- Further research into novel therapeutic strategies for COVID-19-related kidney disease.
- Potential for eculizumab and other complement inhibitors in clinical trials.
- Importance of global collaboration in understanding and managing renal complications of COVID-19.
Abstract:
COVID-19 is a global pandemic fuelled in some countries by government actions. The current issue of Clinical Kidney Journal presents 15 articles on COVID-19 and kidney disease from three continents, providing a global perspective of the impact of severe acute respiratory syndrome coronavirus 2 on electrolytes and different kidney compartments (glomeruli, tubules and vascular compartments) and presenting clinically as a syndrome of inappropriate antidiuretic hormone secretion, acute kidney injury, acute kidney disease, collapsing glomerulopathy and thrombotic microangiopathy, among others, in the context of a brand-new cardiorenal syndrome. Kidney injury may need acute dialysis that may overwhelm haemodialysis (HD) and haemofiltration capabilities. In this regard, acute peritoneal dialysis (PD) may be lifesaving. Additionally, pre-existent chronic kidney disease increases the risk of more severe COVID-19 complications. The impact of COVID-19 on PD and HD patients is also discussed, with emphasis on preventive measures. Finally, current therapeutic approaches and potential future therapeutic approaches undergoing clinical trials, such as complement targeting by eculizumab, are also presented.
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