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COVID-19 and the kidney

Mohamed Hassanein1, Yeshwanter Radhakrishnan2, John Sedor3

  • 1Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic.

Cleveland Clinic Journal of Medicine
|October 2, 2020
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect the kidneys, leading to acute kidney injury (AKI). This review covers kidney damage mechanisms, management strategies, and impacts on various kidney patient groups during the COVID-19 pandemic.

Area of Science:

  • Nephrology
  • Virology
  • Infectious Diseases

Background:

  • COVID-19, primarily a respiratory illness, shows significant kidney involvement.
  • The SARS-CoV-2 virus utilizes the angiotensin-converting enzyme 2 receptor, abundant in kidneys, for cell entry.
  • Current understanding of kidney pathology in COVID-19 is rapidly evolving.

Purpose of the Study:

  • To elucidate the pathogenesis of acute kidney injury (AKI) in COVID-19 patients.
  • To outline optimal management strategies for kidney complications associated with COVID-19.
  • To assess the impact of COVID-19 on patients with pre-existing kidney conditions.

Main Methods:

  • Review of current literature on SARS-CoV-2 and kidney pathology.
  • Discussion of viral entry mechanisms into renal cells.
  • Analysis of clinical data regarding AKI in COVID-19.

Main Results:

  • SARS-CoV-2 infection can lead to AKI through various mechanisms.
  • Management requires tailored approaches based on patient's kidney status.
  • COVID-19 poses risks to patients with chronic kidney disease, end-stage kidney disease on dialysis, and transplant recipients.

Conclusions:

  • Kidney involvement is a critical aspect of COVID-19, necessitating focused clinical attention.
  • Effective management of AKI and protection of vulnerable kidney patient populations are paramount.
  • Further research is crucial to fully understand and mitigate the renal consequences of SARS-CoV-2 infection.

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