[Acute kidney injury in the pathogenesis of coronavirus infection]

V N Pavlov1, A I Tarasenko2, A O Papoyan3

  • 1FSBEI HE Bashkir State Medical University of the Ministry of Health of Russia, Ufa, Russia.

Insights

This review examines how COVID-19 impacts kidney function, exploring direct viral effects and secondary damage mechanisms. Understanding these impacts is crucial for preserving kidney health during and after novel coronavirus infection.

Area of Science:

  • Nephrology
  • Virology
  • Infectious Diseases

Background:

  • COVID-19, a novel coronavirus disease, primarily targets the respiratory system but also affects other organs, notably the kidneys.
  • Kidney damage in COVID-19 patients can stem from direct viral invasion of renal cells or secondary complications like immune dysregulation, coagulation issues, and ischemia.

Purpose of the Study:

  • To comprehensively review the multifaceted impact of SARS-CoV-2 (the virus causing COVID-19) infection on kidney function.
  • To elucidate the mechanisms underlying the development of acute kidney injury (AKI) in the context of COVID-19.
  • To highlight the importance of monitoring and preserving renal health in patients with COVID-19.

Main Methods:

  • Systematic literature review of studies investigating COVID-19 and kidney outcomes.
  • Analysis of pathological and clinical data linking SARS-CoV-2 infection to renal damage.
  • Synthesis of evidence on direct viral effects versus indirect pathophysiological pathways affecting the kidneys.

Main Results:

  • Evidence suggests SARS-CoV-2 can directly infect kidney cells, contributing to renal pathology.
  • Secondary mechanisms, including cytokine storms, hypercoagulability, and hypoxic injury, significantly contribute to acute kidney injury in COVID-19.
  • Patients with COVID-19 exhibit a higher incidence of renal impairment, ranging from mild proteinuria to severe acute kidney injury requiring renal replacement therapy.

Conclusions:

  • COVID-19 poses a significant threat to kidney function through both direct and indirect pathways.
  • Early recognition and management of renal complications are essential for improving outcomes in COVID-19 patients.
  • Further research is needed to fully understand long-term renal sequelae and develop targeted therapies.

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