Coronavirus 2019 pandemic and renal diseases: a review of the literature

Abstract

Objectives Most people with coronavirus 2019 (COVID-19) develop mild illness, but a minority may require active medical care because of the acute respiratory distress syndrome, sepsis and septic shock, and multiorgan failure, including acute kidney injury (AKI) and cardiac injury. The effect of this infection in those with chronic kidney disease (CKD) including kidney transplant recipients has not been evaluated properly. We aimed to highlight the effect of COVID-19 on patients with CKD and the preventive measures to be taken in addition to possible therapeutic modalities till the end of May 2020. Patients and methods We have reviewed most of the literature concerning COVID-19 and focused on the renal implications. Results Patients with CKD (especially dialysis patients and kidney transplant recipients) are at high risk of death because comorbidities increase the risk of dying owing to COVID-19; moreover, COVID-19 infection exaggerates comorbidities and causes possible drug interactions. Patients with COVID-19-induced AKI should be seen regularly by nephrologists, because the risk of these patients to develop CKD is high. In this review, we evaluated the different studies dealing with such topic. Conclusion Kidney involvement seems to be frequent in patients with COVID-19 infection, and AKI is an independent predictor of mortality. Management of patients on dialysis will need special precautions with strict protocols to minimize the risk to other patients and health care personnel taking care of these patients. Immunocompromised patients, such as transplant recipients and those who are maintained on immunosuppressive medications, will need special care.