Pathogenesis of Acute Kidney Injury in Coronavirus Disease 2019

Qian, Jie; Wang, Bin; Lv, Lin‐Li; Liu, Bi‐Cheng

doi:10.3389/fphys.2021.586589

Cited by 26 publications

(21 citation statements)

References 62 publications

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“… 14 The overloaded immune response and cytokine storm cause acute tubular necrosis and endothelial injury that may result in a thrombus. 13 This in conjunction with observed erythrocyte aggregates obstructing the lumen of capillaries indicates that abnormal coagulation may also participate in the pathogenesis of AKI in COVID-19. 13 Multiple indirect causes or insulting events also play a role in contributing to AKI in COVID-19 patients, such as medications, hemodynamic instability, hypoxia, acute respiratory distress syndrome, rhabdomyolysis, excessive diuresis, and secondary infections.…”

Section: Discussionmentioning

confidence: 93%

“…Prominent acute proximal tubular necrosis was observed by light microscopy, with loss of brush border, non-isometric vacuolar degeneration and even frank necrosis. 13 Subsequently, endothelial injury, microvascular thrombi, local inflammation and immune cell infiltration have been repeatedly observed in patients with COVID-19 AKI. 14 The overloaded immune response and cytokine storm cause acute tubular necrosis and endothelial injury that may result in a thrombus.…”

Section: Discussionmentioning

confidence: 99%

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Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Bandelac¹,

Shah²,

Purmessur³

et al. 2022

IJNRD

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Purpose To determine the incidence, mortality, stage, and recovery of acute kidney injury (AKI) in COVID-19 patients and further analyze the effect of patient demographics and comorbidities on AKI incidence. Study Design Our study looked at 1545 charts of patients over 18 years old who presented to BronxCare Hospital in NY with a positive SARS-CoV-2 PCR test. Using the KDIGO criteria, any patient presenting with a creatinine of 1.5 times the baseline or that had an increase in creatinine of 0.3mg/dL in 48 hours was diagnosed with AKI. Pregnant patients, patients with end-stage renal disease (ESRD), and patients with a history of renal transplant were excluded. Results The incidence of AKI in COVID-19 patients was 39% (608), and the mortality rate was 58.2% (354). Of the 254 survivors, 74.8% recovered. Moreover, 42.6% (259) of patients with AKI were admitted to the ICU. Twenty-six of our patients received hemodialysis during admission. There was a statistically significant association between AKI and age, race, hypertension (HTN), diabetes mellitus (DM), hepatitis C (HCV), congestive heart failure (CHF), CKD, patient outcome, and days spent in the hospital. Of the 608 patients with AKI, 294 (48.4%), 185 (30.4%) and 129 (21.2%) had AKI stage 1, 2 and 3, respectively. Conclusion Early resource planning is necessary when admitting COVID-19 patients. Nephrology should be consulted early, and measures should be in place to optimize outpatient follow-up in the nephrology clinic. Lastly, the use of nephrotoxic agents should be carefully considered and, if possible, avoided from the time of admission in patients with COVID-19.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Bandelac¹,

Shah²,

Purmessur³

et al. 2022

IJNRD

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“…Apesar da COVID-19 se manifestar principalmente como uma infecção do trato respiratório, os estudos atuais indicam que o vírus é capaz de atingir outros sistemas, como o cardiovascular, gastrointestinal, neurológico, hematopoiético, imunológico e renal (Qian et al, 2021), podendo complicar o quadro clínico dos indivíduos com COVID-19, dependendo da gravidade da infecção.…”

Section: Introductionunclassified

“…Desse modo, após a infecção pulmonar, o vírus pode entrar no sangue, acumular-se no rim e causar danos às células residentes, podendo causar complicações renais leves ou graves, como hematúria, proteinúria e até mesmo Insuficiência Renal Aguda (IRA). Tal situação acarreta em um risco significativamente maior para a piora clínica dos pacientes, podendo Research, Society and Development, v. 11, n. 1, e40811125217, 2022 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v11i1.25217 3 demandar terapia renal substitutiva (TRS), como hemodiálise, e até ocasionar o óbito (Casas-Aparicio et al, 2021;Qian et al, 2021;Hittesdorf et al, 2021;.…”

Section: Introductionunclassified

Complicações renais decorrentes da infecção por SARS-CoV-2 em pessoas com COVID-19 hospitalizadas: scoping review

Lima

Almeida

Nunes

et al. 2022

RSD

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Objetivos: Identificar complicações/sequelas renais decorrentes da infecção por SARS-CoV-2 em pessoas com COVID-19; e descrever a característica de idade da população estudada. Metodologia: Scoping Review realizada nas bases de dados Web of Science, BVS, Cochrane Library, MEDLINE/PubMed, CINAHL, SCOPUS, Embase, LILACS. E nos sites online: ProQuest Dissertations and Theses, Grey Literature e Google Scholar. Os descritores utilizados foram (comorbidity OR sequel OR complications), (kidney diseases OR glomerular disease OR acute kidney injury OR nephropathy) AND (coronavirus OR SARS-CoV-2 OR COVID-19). Critérios de inclusão: artigos em português, inglês e espanhol, com abordagens metodológicas diversas, disponíveis na íntegra, online, publicados no período de 01 de janeiro de 2020 a 29 de setembro de 2021. E de exclusão: pessoas com diagnósticos prévios de patologias renais agudas e/ou crônicas; cartas ao editor; artigos de opinião; editoriais; e notas. Resultados: Selecionaram-se 10 artigos, que evidenciaram que o processo infeccioso causado pelo SARS-CoV-2 pode iniciar com uma leve proteinúria e hematúria, e evoluir para uma injúria renal aguda causada pela diminuição da capacidade de filtração glomerular, que favorece a retenção de algumas escórias nitrogenadas, causando o aumento dos níveis de creatinina e de ureia. Ademais, informaram que indivíduos entre 52-69 anos foram os mais acometidos. Considerações finais: As complicações/sequelas renais decorrentes da infecção por SARS-CoV-2 são: deposição de imunocomplexos nas células renais, proteinúria, hematúria, aumento da creatinina sérica, aumento da ureia nitrogenada no sangue, diminuição da TFG, e IRA estágio 1, 2 e 3. Tais complicações ocorreram principalmente em pessoas com idade ≥ 52 anos.

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“…The mechanism of sepsis-related AKI remains poorly understood. Evidence suggests that it may involve ischemiareperfusion (IR) injury in the glomerulus, nephron inflammation, hypoxia, and overproduction of oxidative stress, cytokines, and chemokines causing tubular injury and mesenchymal cell apoptosis [8,9]. Of these, oxidative stress could be considered as the most common mechanism.…”

mentioning

confidence: 99%

Superoxide Dismutase Reduces Creatinine and NGAL by Restoring Oxidative Balance during Sepsis

et al. 2022

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Sepsis-associated overproduction of reactive oxygen species (ROS) and nitric oxide (NO) during pathogen infection leads to overwhelming oxidative stress, which has been recognized as a primary contributor to acute kidney injury (AKI). Hence, antioxidant therapy has been widely explored in order to find an effective treatment for sepsis-related AKI, in particular by using endogenous antioxidant – superoxide dismutase (SOD). We assessed the effect of oral SOD on the alteration of AKI biomarkers (creatinine and Neutrophil Gelatinase-Associated Lipocalin – NGAL) in endotoxin-induced septic murine. The animals were assigned as a healthy control, a septic control, and three treatment groups (250, 500, and 1000 IU oral SOD). Treatment of SOD was carried out by force-feeding for 16 weeks prior to intraperitoneal injection of lipopolysaccharide (LPS). The sepsis was assessed using the murine sepsis score (MSS) after 12 hours post-LPS injection, where the changes in plasma SOD, ROS, NO, creatinine, and NGAL were measured by enzyme-linked immunosorbent assay (ELISA). During sepsis, SOD was significantly decreased from its baseline level while other biomarkers were significantly increased (p<0.05) – except for NGAL. MSS exhibited a declining trend in SOD dosage-dependent manner, and was significantly different with that of septic control group at SOD dosage of 1000 IU (p<0.05). SOD treatment with a dosage as low as 250 IU could prevent the abnormal expression of the tested biomarkers during sepsis. There were significant reduction of plasma ROS, NO, creatine and NGAL in rats treated with 1000 IU SOD. Our study suggests the protective effect of SOD against sepsis-induced AKI by scavenging ROS and NO. Doi: 10.28991/ESJ-2022-06-02-06 Full Text: PDF

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Pathogenesis of Acute Kidney Injury in Coronavirus Disease 2019

Cited by 26 publications

References 62 publications

Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Complicações renais decorrentes da infecção por SARS-CoV-2 em pessoas com COVID-19 hospitalizadas: scoping review

Superoxide Dismutase Reduces Creatinine and NGAL by Restoring Oxidative Balance during Sepsis

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