Portal de Periódicos da CAPES

Revisão Acesso aberto Produção Nacional Revisado por pares

BIBTEX RIS

A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results

2021; Sociedade Brasileira de Nefrologia; Volume: 43; Issue: 4 Linguagem: Inglês

10.1590/2175-8239-jbn-2020-0204

2175-8239

Inah Maria Drummond Pecly, Rafael Bellotti Azevedo, Elizabeth Silaid Muxfeldt, Bruna Gopp Botelho, Gabriela Girão de Albuquerque, Pedro Henrique P. Diniz, Rodrigo Silva, Cibele Isaac Saad Rodrigues,

Muscle and Compartmental Disorders

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.