Sandbox:Nasrin

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nasrin Nikravangolsefid, MD-MPH [2]

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Acute Kidney Injury in COVID-19

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Synonyms and keywords: Acute Kidney Injury, Acute Renal Failure, AKI, ARF

Pathophysiology

• Angiotensin-converting enzyme 2 (ACE2), which is a primary receptor for SARS-CoV-2 entry into cells, mostly presents in kidneys as well as lungs and heart.
• Despite kidney injury following COVID-19 infection is less frequent than severe lung injury, ACE2: ACE ratio is higher in the kidneys compared to the respiratory system. (1:1 in the kidneys VS 1:20 in the respiratory system)

Causes

• It is thought that AKI following COVID-19 is the result of
  • Sepsis
  • Hypotension

Epidemiology and Demographics

• Early reports from china revealed that COVID-19 rarely involves the kidneys, as Acute Renal Failure was not seen among COVID-19 hospitalized patients and just mild BUN or creatinine rise occurred.
• However, recent study found 75.4% of hospitalized patients with COVID-19 pneumonia developed hematuria, proteinuria, and AKI. But, these findings are not significantly different with other critical diseases.

Risk Factors

• Severe COVID-19 pneumonia and severe acute respiratory distress syndrome are associated with developing AKI.

Natural History, Complications and Prognosis

• Approximately half of the new AKI following COVID-19 is mild with good short-term prognosis.
• If no improvement occurs during follow-up, is contributed to higher mortality.

Diagnosis

Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Interventions | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies