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Related Concept Videos

Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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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...
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Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

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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...
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Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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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...
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Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

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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...
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[COVID-19 effects on the kidney].

K Amann1, P Boor2, T Wiech3

  • 1Abt. Nephropathologie, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland. Kerstin.Amann@uk-erlangen.de.

Der Pathologe
|February 2, 2021
PubMed
Summary
This summary is machine-generated.

Severe acute kidney injury (AKI) is a common complication of coronavirus disease 2019 (COVID-19). Research is ongoing to understand the virus

Keywords:
Acute kidney injuryCoronavirus infectionsElectron microscopyExtracellular trapsSARS-CoV‑2

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Area of Science:

  • Nephrology
  • Virology
  • Pathology

Background:

  • Acute kidney injury (AKI) is a frequent and severe complication of coronavirus disease 2019 (COVID-19), alongside pulmonary disease.
  • The SARS-CoV-2 virus has been identified in kidney tissue, raising concerns for patients with pre-existing kidney conditions, including chronic kidney disease (CKD) and renal transplant recipients.
  • The increasing incidence of renal involvement in COVID-19 patients has spurred significant interest in understanding the underlying pathophysiology, morphology, and viral detection methods within the kidney.

Purpose of the Study:

  • To analyze the pathophysiology and morphology of kidney involvement in severe COVID-19.
  • To evaluate the effectiveness and challenges of different methods for detecting SARS-CoV-2 in renal tissue.
  • To clarify the direct and indirect contributions of SARS-CoV-2 to kidney injury.

Main Methods:

  • Review and analysis of existing autopsy and kidney biopsy studies on COVID-19 patients with renal involvement.
  • Assessment of SARS-CoV-2 RNA detection techniques in renal tissue.
  • Evaluation of electron microscopy for viral visualization, considering potential artefacts.

Main Results:

  • Detection of SARS-CoV-2 RNA in kidney tissue yields reproducible results across studies.
  • Electron microscopy for visualizing SARS-CoV-2 in the kidney is challenging and subject to debate due to artefacts.
  • The precise mechanisms, both direct and indirect, by which COVID-19 affects the kidneys are still under intensive investigation.

Conclusions:

  • Kidney complications, including AKI, are significant in severe COVID-19, particularly for vulnerable patient groups.
  • While viral RNA detection in the kidney is reliable, morphological analysis requires careful interpretation.
  • Further research is crucial to fully elucidate the complex interplay between SARS-CoV-2 and kidney injury.