New insights into kidney disease after COVID-19 infection and vaccination: histopathological and clinical findings

Abstract

In addition to its pulmonary effects, COVID-19 has also been found to cause acute kidney injury (AKI), which has been linked to high mortality rates. In this review, we collected data from 20 clinical studies on post-COVID-19-related AKI and 97 cases of AKI associated with COVID-19 vaccination. Acute tubular injury was by far the most common finding in the kidneys of patients with COVID-19-related AKI. Among patients hospitalized for COVID-19, 34.0% developed AKI, of which 59.0%, 19.1%, and 21.9% were stage 1, 2, and 3, respectively. Though kidney disease and other adverse effects after COVID-19 vaccination overall appear rare, case reports have accumulated suggesting that COVID-19 vaccination may be associated with a risk of subsequent kidney disease. Among the patients with post-vaccination AKI, the most common pathologic findings include crescentic glomerulonephritis (29.9%), acute tubular injury (23.7%), IgA nephropathy (18.6%), ANCA-associated vasculitis (17.5%), minimal change disease (17.5%), and thrombotic microangiopathy (10.3%). It is important to note that crescentic glomerulonephritis appears to be more prevalent in patients who have newly diagnosed renal involvement. The proportions of patients with AKI stages 1, 2, and 3 after COVID-19 vaccination in case reports were 30.9%, 22.7%, and 46.4%, respectively. In general, clinical cases of new-onset and recurrent nephropathy with AKI after COVID-19 vaccination have a positive prognosis. In this article, we also explore the underlying pathophysiological mechanisms of AKI associated with COVID-19 infection and its vaccination by describing key renal morphological and clinical features and prognostic findings.

Research on the global trends of COVID-19 associated acute kidney injury: a bibliometric analysis

“…According to Li Yebei et al. among patients with post-vaccination AKI who undergo kidney biopsy, the most common pathological diagnoses was crescentic glomerulonephritis, followed by acute tubular injury, IgA nephropathy, ANCA-associated vasculitis, minimal change disease, and thrombotic microangiopathy [ 46 ]. Research has identified specific biomarkers of renal injury, including functional biomarkers (Cys C), injury biomarkers (KIM-1, NGAL), and stress biomarkers (TIMP-2 and IGFBP7), which may be beneficial for the early diagnosis of COVID-19 AKI [ 30 , 47 , 48 ].…”