Lessons for the clinical nephrologist: recurrence of nephrotic syndrome induced by SARS-CoV-2

Doevelaar, Adrian; Hölzer, Bodo; Seibert, Felix S.; Bauer, Frederic; Stervbo, Ulrik; Rohn, Benjamin; Zgoura, Panagiota; Schenker, Peter; Vonbrunn, Eva; Amann, Kerstin; Viebahn, Richard; Babel, Nina; Westhoff, Timm H.

doi:10.1007/s40620-020-00855-5

Cited by 17 publications

(21 citation statements)

References 9 publications

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“…This represents a 1.28-fold increase in mortality compared to a matched dialysis cohort, making renal transplant patients a particularly vulnerable population, presumably due to the underlying renal disease and multiple comorbidities. However, in addition to increased mortality, COVID-19 infection in renal transplant patients also appears to have other functional effects, as illustrated by numerous case reports that have now been published [ 15 , 16 ].…”

Section: Covid-19 Renal Symptomatology In Chronic Kidney Disease and mentioning

confidence: 99%

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COVID-19 effects on the kidney

Amann¹,

Wiech

Singh

et al. 2021

Pathologe

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Apart from pulmonary disease, acute kidney injury (AKI) is one of the most frequent and most severe organ complications in severe coronavirus disease 2019 (COVID-19). The SARS-CoV‑2 virus has been detected in renal tissue. Patients with chronic kidney disease (CKD) before and on dialysis and specifically renal transplant patients represent a particularly vulnerable population. The increasing number of COVID-19 infected patients with renal involvement led to an evolving interest in the analysis of its pathophysiology, morphology and modes of virus detection in the kidney. Meanwhile, there are ample data from several autopsy and kidney biopsy studies that differ in the quantity of cases as well as in their quality. While the detection of SARS-CoV‑2 RNA in the kidney leads to reproducible results, the use of electron microscopy for visualisation of the virus is difficult and currently critically discussed due to various artefacts. The exact contribution of indirect or direct effects on the kidney in COVID-19 are not yet known and are currently the focus of intensive research.

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Section: Covid-19 Renal Symptomatology In Chronic Kidney Disease and mentioning

confidence: 99%

“…For this purpose, complementary probes are used, which bind specifically to the viral RNA. This binding can be visualized using fluorescent (FISH) or chromogenic (CISH) dyes [ 15 , 16 ]. This method is somewhat more complex but offers a cell-specific analysis of the virus location.…”

Section: Sars-cov-2 Pathogen Diagnostics On Fixed Kidney Tissuementioning

confidence: 99%

COVID-19 effects on the kidney

Amann¹,

Wiech

Singh

et al. 2021

Pathologe

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“…In kidney transplant patients there is scarce information on histological findings. In patients with AKI, apart from acute tubular injury, minimal change disease [ 49 ], cortical necrosis [ 50 ] and collapsing glomerulopathy [ 51–53 ] have also been described. In addition, very few cases of T cell– or antibody-mediated rejection have been described, raising the question of whether COVID-19 infection may enhance the alloimmune response [ 46 , 50 ].…”

Section: Aki and Histologymentioning

confidence: 99%

Kidney transplantation and COVID-19 renal and patient prognosis

Toapanta

Sellarès

Chamoun

et al. 2021

Clinical Kidney Journal

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Coronavirus disease 2019 (COVD-19) emerged as a pandemic in December 2019. Infection has spread quickly and renal transplant recipients receiving chronic immunosuppression have been considered a population at high risk of infection, complications and infection-related death. During this year a large amount of information from nationwide registries, multicentre and single-centre studies have been reported. The number of renal transplant patients diagnosed with COVID-19 was higher than in the general population, but the lower threshold for testing may have contributed to its better identification. Major complications such as acute kidney injury and acute respiratory distress syndrome were very frequent in renal transplant patients, with a high comorbidity burden, but further studies are needed to support that organ transplant recipients receiving chronic immunosuppression are more prone to develop these complications than the general population. Kidney transplant recipients experience a high mortality rate compared with the general population, especially during the very early post-transplant period. Despite the fact that some studies report more favourable outcomes in patients with a kidney transplant than in patients on the kidney waiting list, the higher mortality described in the very early post-transplant period would advise against performing a kidney transplant in areas where the spread of infection is high, especially in recipients >60 years of age. Management of transplant recipients has been challenging for clinicians and strategies such as less use of lymphocyte-depleting agents for new transplants or anti-metabolite withdrawal and calcineurin inhibitor reduction for transplant patients with COVID-19 are not based on high-quality evidence.

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“…Hierzu verwendet man komplementäre Sonden, die sich am histologischen Schnitt spezifisch an die Virus-RNA binden. Diese Bindung kann man mittels Fluoreszenz(FISH)- oder Chromogen(CISH)-Farbstoffen visualisieren [ 15 , 16 ]. Diese Methodik ist etwas aufwendiger, bietet jedoch eine örtliche und zellspezifische Analyse der Viruslokalisation.…”

Section: Sars-cov-2-erregerdiagnostik Am Fixierten Nierengewebeunclassified

COVID-19-Auswirkungen auf die Niere

et al. 2021

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Bei einer schweren Coronavirus-Erkrankung-2019 (COVID-19) ist neben der Lungenerkrankung selbst das akute Nierenversagen (ANV) eine der häufigsten und schwerwiegendsten Komplikationen. Das SARS-CoV-2-Virus konnte hierbei auch in der Niere nachgewiesen werden. Patienten mit chronischen Nierenerkrankungen (CKD), dialysepflichtige sowie v. a. nierentransplantierte Patienten scheinen eine besonders vulnerable Population darzustellen. Die zunehmende Anzahl SARS-CoV-2-infizierter Patienten hat das Interesse an der genauen Pathophysiologie und Morphologie der Nierenschädigung sowie am direkten Virusnachweis in der Niere geweckt, der im Gegensatz zur Lunge insgesamt schwieriger zu führen ist. Hierzu liegen mittlerweile Daten aus Autopsie- und Nierenbiopsiestudien mit unterschiedlichen Patientenzahlen und von sehr unterschiedlicher Qualität vor. Während der Nachweis von SARS-CoV-2-RNA im Nierengewebe mit gut reproduzierbaren Ergebnissen erfolgt, ist insbesondere der Virusnachweis mittels Elektronenmikroskopie schwierig und wird aufgrund zahlreicher Artefakte derzeit kritisch diskutiert. Die genauen direkten oder indirekten Effekte von SARS-CoV‑2 auf die Niere sind noch nicht im Detail bekannt und derzeit der Fokus intensiver Forschung.

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Lessons for the clinical nephrologist: recurrence of nephrotic syndrome induced by SARS-CoV-2

Cited by 17 publications

References 9 publications

COVID-19 effects on the kidney

COVID-19 effects on the kidney

Kidney transplantation and COVID-19 renal and patient prognosis

COVID-19-Auswirkungen auf die Niere

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