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Viral Nephropathies: Core Curriculum 2024
Amy A Yau1, Sangeetha Murugapandian2, Ali W Rizvi1
1Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Summary
Viral infections can cause kidney disease (viral-associated nephropathy) through direct damage or immune responses. Understanding viral causes, injury mechanisms, and treatments is crucial for patient care.
Area of Science:
- Nephrology
- Virology
- Immunology
Background:
- Viral-associated nephropathy is a significant global health concern due to the high prevalence of viral infections.
- Viruses like Hepatitis B, C, HIV, and SARS-CoV-2 are common causes, while others like EBV, CMV, and polyoma virus affect immunosuppressed individuals.
- Hantavirus and dengue virus present rare but severe kidney manifestations despite high infectivity.
Purpose of the Study:
- To review common viruses causing kidney disease worldwide.
- To discuss the pathogenesis and mechanisms of kidney injury in viral nephropathies.
- To highlight current management principles and antiviral therapy options.
Main Methods:
- Review of existing literature on viral-associated nephropathy.
- Analysis of viral mechanisms leading to glomerular and tubulointerstitial lesions.
- Discussion of direct viral infection versus indirect immune-mediated injury.
Main Results:
- Viral nephropathies manifest as glomerular and tubulointerstitial lesions in acute and chronic infections.
- Pathogenesis involves direct viral invasion, immune system activation, and hemodynamic alterations.
- Genetic factors like APOL1 polymorphisms influence susceptibility in HIV- and SARS-CoV-2-associated nephropathies.
Conclusions:
- Advances in understanding viral pathogenesis and antiviral therapies improve outcomes for viral-associated nephropathy.
- Effective management requires awareness of specific viral culprits, injury patterns, and host factors.
- Further research is needed for viruses with high endemicity but low reported kidney disease incidence.
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