Acute tubulointerstitial nephritis and COVID-19

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Jia H Ng1, Mohamad Zaidan2, Kenar D Jhaveri1

  • 1Department of Medicine, Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA.

Clinical Kidney Journal
|October 4, 2021
PubMed

Insights

Acute kidney injury is common in Coronavirus disease 2019 (COVID-19). Kidney biopsies reveal acute tubular injury as the most frequent finding, while interstitial kidney disease is rare in COVID-19 patients.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pathology

Background:

  • Coronavirus disease 2019 (COVID-19) is a global pandemic.
  • Acute kidney injury (AKI) is a frequent complication of COVID-19.
  • Kidney biopsy findings in COVID-19 patients are still being characterized.

Purpose of the Study:

  • To summarize the spectrum of kidney pathology observed in patients with COVID-19.
  • To highlight the prevalence of specific kidney injuries, including acute tubular injury and glomerular diseases.
  • To assess the occurrence of interstitial kidney disease in the context of COVID-19.

Main Methods:

  • Review of published kidney biopsy series from patients with COVID-19.
  • Analysis of histopathological findings, including light microscopy, immunofluorescence, and electron microscopy.
  • Correlation of kidney findings with clinical presentation and disease severity.

Main Results:

  • Acute tubular injury is the most common finding on kidney biopsies.
  • Glomerular diseases like collapsing glomerulopathy, vasculitis, and thrombotic microangiopathy have been reported.
  • Interstitial infiltrates and interstitial nephritis are uncommon in COVID-19 patients, despite potential medication side effects.

Conclusions:

  • The primary kidney pathology in COVID-19 involves acute tubular injury.
  • While glomerular and thrombotic microangiopathic lesions can occur, interstitial kidney disease is a rare manifestation of COVID-19.

Keywords:
SARS-CoV-2acute tubulointerstitial nephritiscoronavirus

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