Back to Search
Start Over
A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results
- Source :
- Brazilian Journal of Nephrology, Vol 43, Iss 4, Pp 551-571 (2021), Brazilian Journal of Nephrology v.43 n.4 2021, Jornal Brasileiro de Nefrologia, Sociedade Brasileira de Nefrologia (SBN), instacron:SBN
- Publication Year :
- 2021
- Publisher :
- FapUNIFESP (SciELO), 2021.
-
Abstract
- Acute kidney injury (AKI) in hospitalized patients with COVID-19 is associated with higher mortality and a worse prognosis. Nevertheless, most patients with COVID-19 have mild symptoms, and about 5% can develop more severe symptoms and involve hypovolemia and multiple organ dysfunction syndrome. In a pathophysiological perspective, severe SARS-CoV-2 infection is characterized by numerous dependent pathways triggered by hypercytokinemia, especially IL-6 and TNF-alpha, leading to systemic inflammation, hypercoagulability, and multiple organ dysfunction. Systemic endotheliitis and direct viral tropism to proximal renal tubular cells and podocytes are important pathophysiological mechanisms leading to kidney injury in patients with more critical infection, with a clinical presentation ranging from proteinuria and/or glomerular hematuria to fulminant AKI requiring renal replacement therapies. Glomerulonephritis, rhabdomyolysis, and nephrotoxic drugs are also associated with kidney damage in patients with COVID-19. Thus, AKI and proteinuria are independent risk factors for mortality in patients with SARS-CoV-2 infection. We provide a comprehensive review of the literature emphasizing the impact of acute kidney involvement in the evolutive prognosis and mortality of patients with COVID-19.
- Subjects :
- medicine.medical_specialty
Fulminant
030232 urology & nephrology
Review
030204 cardiovascular system & hematology
urologic and male genital diseases
Systemic inflammation
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Mortality
Kidney
SARS-CoV-2
Coronavirus Infection
urogenital system
business.industry
Organ dysfunction
Acute kidney injury
COVID-19
Glomerulonephritis
General Medicine
Acute Kidney Injury
medicine.disease
Diseases of the genitourinary system. Urology
Renal Replacement Therapy
Proteinuria
medicine.anatomical_structure
Cytokines
RC870-923
Inflammation Mediators
Morbidity
medicine.symptom
Multiple organ dysfunction syndrome
business
Rhabdomyolysis
Subjects
Details
- ISSN :
- 21758239 and 01012800
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- Brazilian Journal of Nephrology
- Accession number :
- edsair.doi.dedup.....6371118aecdb1f3c106adceea80f54e4