Renal changes and acute kidney injury in covid-19: a systematic review.

OBJECTIVE: We aimed to present a review of renal changes in patients with COVID-19. METHODS: We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords "COVID-19", "coronavirus", "SARS-CoV-2", "kidney injury" and "kidney disease". Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION: Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION: Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.

Renal changes and acute kidney injury in covid-19: a systematic review

SUMMARY OBJECTIVE We aimed to present a review of renal changes in patients with COVID-19. METHODS We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords "COVID-19", "coronavirus", "SARS-CoV-2", "kidney injury" and "kidney disease". Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.

RESUMO OBJETIVO Apresentar uma revisão sobre as alterações renais nos pacientes com COVID-19. MÉTODOS Foi realizada uma revisão sistemática de literatura para buscar estudos referentes a pacientes com alterações renais clínicas, laboratoriais e anatomopatológicas durante a infecção por SARS-CoV-2. A busca foi realizada nas bases de dados eletrônicos PubMed, Scopus e Embase, com as palavras-chaves: "COVID-19", "coronavirus", "Sars-CoV-2", "kidney injury" e "kidney disease", para identificar artigos originais publicados na literatura até 07 de maio de 2020. Quinze estudos trouxeram alterações renais clínicas e laboratoriais dos pacientes com COVID-19, e três abordaram análises anatomopatológicas. DISCUSSÃO A Lesão renal aguda (LRA) foi um achado relevante nos pacientes com COVID-19. Houve também alterações significativas nos exames laboratoriais que indicam lesão renal, como o nível de creatinina e ureia séricas, proteinúria e hematúria. As alterações laboratoriais e a LRA foram importantes nos pacientes que desenvolveram o quadro grave da doença. Há considerável prevalência de LRA nos grupos de pacientes que vieram a óbito. Na análise histopatológica de pacientes com SARS-CoV-2 foram encontrados achados renais sugestivos que o vírus poderia ter efeitos diretos sobre o rim. CONCLUSÃO A COVID-19 é uma doença que, apesar de acometer principalmente os pulmões, também acomete os rins. Aumento das escórias nitrogenadas, hematúria, proteinúria e LRA foram achados frequentes em pacientes com quadros graves da COVID-19. Esses achados foram relacionados a maior mortalidade. É necessária a realização de mais estudos com enfoque nas alterações renais e suas implicações no quadro clínico causadas pelo novo coronavírus.

Fatal disseminated strongyloidiasis after kidney transplantation.

Disseminated strongyloidiasis (DS) is a rare and severe parasitic disease that is difficult to recognize and affects immunocompromised individuals. We report the case of a kidney transplant recipient who presented with DS despite prophylaxis with albendazole. We have discussed the need for better prophylactic strategies and for a higher degree of suspicion in order to diagnose DS.

Fatal disseminated strongyloidiasis after kidney transplantation / Estrongiloidíase disseminada fatal após transplante renal

Disseminated strongyloidiasis (DS) is a rare and severe parasitic disease that is difficult to recognize and affects immunocompromised individuals. We report the case of a kidney transplant recipient who presented with DS despite prophylaxis with albendazole. We have discussed the need for better prophylactic strategies and for a higher degree of suspicion in order to diagnose DS.

A estrongiloidíase disseminada (ED) é uma doença parasitária rara de difícil diagnóstico que acomete indivíduos imunocomprometidos. Relatamos um caso de um paciente transplantado renal que desenvolveu ED apesar do uso de profilaxia com albendazol. São discutidas estratégias profiláticas e de diagnóstico da estrongiloidíase disseminada.

[Acute renal failure following bee stings: case reports]. / Insuficiência renal aguda por picada de abelhas: relato de casos.

Rhabdomyolysis is a syndrome characterized by muscle injury, most frequently due to muscle crushing and trauma. However, it may also be induced by non-traumatic causes, for example by means of stinging by Africanized bees. We describe two cases of rhabdomyolysis that presented dialytic acute renal failure after several bee stings.

Insuficiência renal aguda por picada de abelhas: relato de casos / Acute renal failure following bee stings: case reports

Rabdomiólise é uma síndrome caracterizada por injúria muscular, mais freqüentemente decorrente de esmagamento e traumas musculares. No entanto, a rabdomiólise pode ter também causas não traumáticas, como por exemplo, picadas de abelhas africanizadas. Descrevemos dois casos de rabdomiólise que apresentaram insuficiência renal aguda dialítica após várias picadas de abelhas.

Rhabdomyolysis is a syndrome characterized by muscle injury, most frequently due to muscle crushing and trauma. However, it may also be induced by non-traumatic causes, for example by means of stinging by Africanized bees. We describe two cases of rhabdomyolysis that presented dialytic acute renal failure after several bee stings.