RESUMO
Initial reports suggested that kidney involvement after coronavirus disease 19 (COVID-19) infection was uncommon, but this premise appears to be incorrect. Acute kidney injury can occur through various mechanisms and complicate the course of up to 25% of patients with COVID-19 hospitalized in our Institution, and of over 50% of those on invasive mechanical ventilation. Mechanisms of injury include direct kidney injury and predominantly tubular, although glomerular injury has been reported, and resulting from severe hypoxic respiratory failure, secondary infection, and exposure to nephrotoxic drugs. The mainstay of treatment remains the prevention of progressive kidney damage and, in some cases, the use of renal replacement therapy. Although the use of blood purification techniques has been proposed as a potential treatment, results to date have not been conclusive. In this manuscript, the mechanisms of kidney injury by COVID-19, risk factors, and the mainstays of treatment are reviewed.
Assuntos
Injúria Renal Aguda , COVID-19 , Humanos , COVID-19/complicações , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/terapia , RimAssuntos
Injúria Renal Aguda/terapia , COVID-19/complicações , Pandemias , Terapia de Substituição Renal/métodos , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/imunologia , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/terapia , Tomada de Decisão Clínica , Alocação de Recursos para a Atenção à Saúde/economia , Humanos , América Latina/epidemiologia , Terapia de Substituição Renal/efeitos adversos , Terapia de Substituição Renal/economia , Terapia de Substituição Renal/instrumentação , Fatores de Risco , SARS-CoV-2/imunologia , SARS-CoV-2/isolamento & purificaçãoRESUMO
Lung transplantation is the gold standard therapy for patients in the end stages of pulmonary disease. However, in numerous countries, candidates for lung transplants often die on the waiting list due to a shortage of donors and limited access to transplant centers. This article delves into the experience of our hospital, Christus Muguerza in Monterrey, Mexico, as the sole active lung transplant program in the country, having conducted 35 transplants from August 2017 to March 2023. We discuss the actual situation of lung transplantation in Mexico and the challenges we have faced over time, such as late patient referrals for evaluation and eventual transplantation. In addition, we outline the challenges we anticipate as more transplant programs emerge in the country.
Assuntos
Disuria , Rim Único , Humanos , Disuria/etiologia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologiaRESUMO
ABSTRACT Initial reports suggested that kidney involvement after coronavirus disease 19 (COVID-19) infection was uncommon, but this premise appears to be incorrect. Acute kidney injury can occur through various mechanisms and complicate the course of up to 25% of patients with COVID-19 hospitalized in our Institution, and of over 50% of those on invasive mechanical ventilation. Mechanisms of injury include direct kidney injury and predominantly tubular, although glomerular injury has been reported, and resulting from severe hypoxic respiratory failure, secondary infection, and exposure to nephrotoxic drugs. The mainstay of treatment remains the prevention of progressive kidney damage and, in some cases, the use of renal replacement therapy. Although the use of blood purification techniques has been proposed as a potential treatment, results to date have not been conclusive. In this manuscript, the mechanisms of kidney injury by COVID-19, risk factors, and the mainstays of treatment are reviewed.