Kidney Issues Associated with COVID-19 Disease

P. Dousdampanis, A. Mouzaki, K. Trigka, I. Stefanidis, Konstantinos-Eugenios Galanopoulos, Ioannis-Santo Siavelis, Dionysia Stathopoulou, S. Assimakopoulos
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Abstract

Infection with SARS-CoV-2 and the resulting COVID-19 can cause both lung and kidney damage. SARS-CoV-2 can directly infect renal cells expressing ACE2 receptors, resulting in kidney damage, and acute kidney injury (AKI) has been reported in COVID-19 hospitalized patients. The pathophysiology of COVID-19-associated AKI is multifactorial. Local and systemic inflammation, immune system dysregulation, blood coagulation disorders, and activation of the renin-angiotensin-aldosterone system (RAAS) are factors that contribute to the development of AKI in COVID 19 disease. COVID-19 patients with kidney involvement have a poor prognosis, and patients with chronic kidney disease (CKD) infected with SARS-CoV-2 have an increased mortality risk. CKD patients with COVID-19 may develop end-stage renal disease (ESRD) requiring dialysis. In particular, patients infected with SARS-CoV-2 and requiring dialysis, as well as patients who have undergone kidney transplantation, have an increased risk of mortality and require special consideration. Nephrologists and infectious disease specialists face several clinical dilemmas in the prophylaxis and treatment of CKD patients with COVID-19. This entry presents recent data showing the effects of COVID-19 on the kidneys and CKD patients and the challenges in the management of CKD patients with COVID-19, and discusses treatment strategies for these patients.
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与新冠肺炎疾病相关的肾脏问题
感染SARS-CoV-2和由此产生的新冠肺炎可能会导致肺和肾损伤。SARS-CoV-2可直接感染表达ACE2受体的肾细胞,导致肾损伤,据报道,新冠肺炎住院患者出现急性肾损伤(AKI)。COVID-19相关AKI的病理生理学是多因素的。局部和全身炎症、免疫系统失调、凝血障碍以及肾素-血管紧张素-醛固酮系统(RAAS)的激活是导致COVID-19疾病中AKI发展的因素。肾脏受累的新冠肺炎患者预后不良,感染SARS-CoV-2的慢性肾脏疾病(CKD)患者的死亡率增加。患有新冠肺炎的CKD患者可能会发展为需要透析的终末期肾病(ESRD)。特别是,感染严重急性呼吸系统综合征冠状病毒2型并需要透析的患者,以及接受过肾移植的患者,死亡率增加,需要特别考虑。肾病学家和传染病专家在预防和治疗新冠肺炎CKD患者方面面临着几个临床难题。本条目介绍了最近的数据,显示了新冠肺炎对肾脏和CKD患者的影响,以及新冠肺炎CKD患者管理方面的挑战,并讨论了这些患者的治疗策略。
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