Kidney disease in the coronavirus disease-2019 pandemic

Abstract

While primary SARS-CoV-2 infection follows droplet and airborne transmission through the respiratory route, patients with COVID-19 pneumonia and secondary hyperinflammatory syndrome have been reported to have extrapulmonary complications. Symptoms and findings include neurological (headaches, encephalopathy, Guillain-Barre syndrome, and stroke), cardiac (acute cardiomyopathy, myocarditis, arrhythmias, and acute cor pulmonale), renal (acute kidney injury [AKI], proteinuria, and hematuria), hepatic (elevated transaminases and bilirubin), gastrointestinal (nausea, vomiting, abdominal pain, and diarrhea), hematologic (deep venous thrombosis, pulmonary embolism, and intravascular catheter-associated thrombosis), and dermatologic (livedo reticularis, urticaria, vesicles, and lupus pernio-like lesions). [3,4] Furthermore, Abstract While Coronavirus disease-2019 (COVID-19) is primarily a respiratory tract infection in most cases of mild to moderate disease, severe disease can involve multi-organ failure including acute kidney injury (AKI). COVID-19-associated AKI may require renal replacement therapy (RRT) in the acute setting or chronically after hospital discharge. The COVID-19 pandemic presented considerable difficulties to the nephrology community, requiring epidemiologic, clinical, and pathologic studies of AKI associated with the acute phase of infection. In this review article, AKI studies, pathologic entities, and specific adaptations to RRT will be discussed. mortality, with 37.5 deaths per 1000 patient-days among AKI patients versus 10.8 deaths per 1000 patient-days among non-AKI patients. Forty-three percent of patients with AKI had abnormal kidney function at time of hospital discharge.