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A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results.
Pecly, Inah Maria D; Azevedo, Rafael B; Muxfeldt, Elizabeth S; Botelho, Bruna G; Albuquerque, Gabriela G; Diniz, Pedro Henrique P; Silva, Rodrigo; Rodrigues, Cibele I S.
  • Pecly IMD; Universidade Estácio de Sá, Curso de Medicina, Rio de Janeiro, RJ, Brasil.
  • Azevedo RB; Universidade Estácio de Sá, Curso de Medicina, Rio de Janeiro, RJ, Brasil.
  • Muxfeldt ES; Universidade Estácio de Sá, Curso de Medicina, Rio de Janeiro, RJ, Brasil.
  • Botelho BG; Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, RJ, Brasil.
  • Albuquerque GG; Universidade Estácio de Sá, Curso de Medicina, Rio de Janeiro, RJ, Brasil.
  • Diniz PHP; Universidade Estácio de Sá, Curso de Medicina, Rio de Janeiro, RJ, Brasil.
  • Silva R; Universidade Estácio de Sá, Curso de Medicina, Rio de Janeiro, RJ, Brasil.
  • Rodrigues CIS; Universidade Estácio de Sá, Curso de Medicina, Rio de Janeiro, RJ, Brasil.
J Bras Nefrol ; 43(4): 551-571, 2021.
Article in English, Portuguese | MEDLINE | ID: covidwho-1575271
ABSTRACT
Acute kidney injury (AKI) in hospitalized patients with COVID-19 is associated with higher mortality and a worse prognosis. Nevertheless, most patients with COVID-19 have mild symptoms, and about 5% can develop more severe symptoms and involve hypovolemia and multiple organ dysfunction syndrome. In a pathophysiological perspective, severe SARS-CoV-2 infection is characterized by numerous dependent pathways triggered by hypercytokinemia, especially IL-6 and TNF-alpha, leading to systemic inflammation, hypercoagulability, and multiple organ dysfunction. Systemic endotheliitis and direct viral tropism to proximal renal tubular cells and podocytes are important pathophysiological mechanisms leading to kidney injury in patients with more critical infection, with a clinical presentation ranging from proteinuria and/or glomerular hematuria to fulminant AKI requiring renal replacement therapies. Glomerulonephritis, rhabdomyolysis, and nephrotoxic drugs are also associated with kidney damage in patients with COVID-19. Thus, AKI and proteinuria are independent risk factors for mortality in patients with SARS-CoV-2 infection. We provide a comprehensive review of the literature emphasizing the impact of acute kidney involvement in the evolutive prognosis and mortality of patients with COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Prognostic study Limits: Humans Language: English / Portuguese Journal: J Bras Nefrol Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: 2175-8239-JBN-2020-0204

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury / COVID-19 Type of study: Prognostic study Limits: Humans Language: English / Portuguese Journal: J Bras Nefrol Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: 2175-8239-JBN-2020-0204