COVID-19 and acute kidney injury

Lale A Ertuğlu1, Asiye Kanbay2, Barış Afşar3

  • 1Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey.

Tuberkuloz Ve Toraks
|January 15, 2021
PubMed

Insights

COVID-19 significantly impacts kidneys, causing acute kidney injury (AKI) in severe cases. Understanding AKI mechanisms and implementing protective measures is crucial for patient outcomes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Virology

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, has led to widespread health issues globally.
  • Kidney damage, including proteinuria, hematuria, and AKI, is frequently observed in hospitalized COVID-19 patients.
  • Acute kidney injury (AKI) is particularly common in severe and critical COVID-19 cases and is linked to increased mortality.

Purpose of the Study:

  • To review the prevalence and outcomes of AKI in COVID-19 patients.
  • To explore the potential mechanisms underlying COVID-19-associated kidney damage.
  • To suggest strategies for preventing kidney injury in COVID-19.

Main Methods:

  • Review of current literature on COVID-19 and kidney injury.
  • Analysis of histopathological findings in kidney tissues from COVID-19 patients.
  • Discussion of potential therapeutic targets and organ-protective measures.

Main Results:

  • COVID-19 frequently causes kidney damage, with AKI being a significant predictor of mortality.
  • Pathological findings suggest direct SARS-CoV-2 infection of renal cells and acute tubular necrosis.
  • Other contributing factors may include rhabdomyolysis and glomerulopathies.

Conclusions:

  • AKI is a serious complication of COVID-19 with unclear pathophysiology.
  • Further research into antiviral and anti-inflammatory treatments is ongoing.
  • Organ-protective strategies are essential for managing kidney health during the pandemic.

Related Concept Videos

Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
297
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
139
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
553
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
446
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
129
Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
195