Kidney injury in patients who have contracted coronavirus disease: status of the problem today

B.V. Horban
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Abstract

As of January 2021, 87.6 million cases of COVID-19 have been registered in the world, of which 1.9 million cases have resulted in death. In Ukraine, at the end of 2020, the number of cases of the disease was 1,099,493, of which 19,505 resulted in death. The progressive course of COVID-19 can induce severe damage to the lungs, kidneys, heart and other organs and systems with the formation of acute respiratory distress syndrome and multiple organ failure syndrome. Kidney damage in the case of COVID-19 is still considered to be mainly secondary and associated with hypoxia, ischemia, disseminated intravascular coagulation in the case of severe and extremely severe disease. However, it is worth noting that kidney damage also occurs against the background of the massive use of medications that are sufficiently nephrotoxic.The purpose of this work is to review scientific results, which contain information about the current state of the problem of kidney damage in patients who have contracted the coronavirus disease.Patients with chronic kidney disease have an increased risk of infection with COVID-19, its severe course and mortality. Endothelial dysfunction, microangiopathy, coagulation disorders, and imbalance of the renin-angiotensin-aldosterone system are key links to kidney damage in the case of such concomitant pathology. An increase in the level of serum creatinine and blood urea nitrogen, the appearance and increase in the level of hematuria and proteinuria - these changes require careful study.Conclusions. 1. To date, scientific data on the mechanisms of kidney damage in patients with COVID-19 have been expanded. This makes it possible to develop methods of timely drug exposure to prevent the progression of renal function decline. 2. The incidence of acute kidney injury and mortality in COVID-19 patients with CKD is significantly higher than without CKD. 3. After recovery from COVID-19, patients with CKD should have dispensary observation and treatment.
冠状病毒感染患者的肾损伤:当今问题的现状
截至2021年1月,全球已登记了8760万例COVID-19病例,其中190万例已导致死亡。在乌克兰,截至2020年底,该病病例数为1,099,493例,其中19,505例导致死亡。COVID-19的进展过程可对肺、肾脏、心脏等器官和系统造成严重损害,形成急性呼吸窘迫综合征和多器官衰竭综合征。COVID-19病例的肾脏损害仍被认为主要是继发性的,在重症和极重症病例中与缺氧、缺血、弥散性血管内凝血有关。然而,值得注意的是,在大量使用具有足够肾毒性的药物的背景下,肾脏损害也会发生。这项工作的目的是审查科学结果,其中包含有关感染冠状病毒的患者肾脏损害问题现状的信息。慢性肾脏疾病患者感染COVID-19的风险增加,其严重病程和死亡率增加。内皮功能障碍、微血管病变、凝血功能障碍和肾素-血管紧张素-醛固酮系统失衡是这些伴随病理的肾损害的关键环节。血清肌酐和尿素氮水平升高,血尿和蛋白尿的出现和升高——这些变化需要仔细研究。1. 迄今为止,关于COVID-19患者肾损害机制的科学数据已经扩大。这使得开发及时药物暴露的方法来防止肾功能下降的进展成为可能。2. 合并CKD的COVID-19患者急性肾损伤发生率和死亡率明显高于未合并CKD的患者。3.CKD患者在COVID-19康复后,应进行药房观察和治疗。
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