Mechanisms of kidney injury in COVID-19 and diagnostic methods

Profilakticheskaya Meditsina Pub Date : 2023-01-01 DOI:10.17116/profmed202326011114

S. Dzugkoev, F. Dzugkoeva, O. I. Margieva, A. E. Khubulova

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Abstract

The COVID-19 pandemic is a global healthcare crisis. The frequency of acute kidney injury (AKI) in patients with COVID-19 and the features of its diagnostics indicate the relevance of the topic. Objective of the review. To analyze mechanisms of AKI development in patients with COVID-19 and provide support for methodological approaches to ensure its timely diagnosis. Material and methods. The methodological approaches used in the review are based on a sufficient number of literature sources (more than 150 sources), of which 34 articles are included in the review: 15 original studies, 12 reviews, 2 meta-analyses, 5 re-ports, and letters to the editor. Results. The mechanisms of AKI development and progression, including the direct cytotoxic effect of the SARS-CoV-2 virus, dis-ruption of metabolic pathways of renal blood flow regulation, and the complement system, are considered. We also analyzed AKI risk factors in patients with acute respiratory distress: diabetes mellitus, chronic kidney injury, arterial hypertension with im-paired NOx production, and eNOS expression as significant factors of vasodilation in renal microcirculatory vessels. The analy-sis showed the most perspective directions in the diagnostics of AKI functional stages. These include molecular test methods (pro-teome and metabolome) in blood and urine;they helped define damage markers to proximal tubules and the glomerular system, thus improving the diagnostics accuracy and validity, therapy efficiency, and end points of disease prognosis. Conclusion. The Coronado study aims to assess the phenotypic features of patients with diabetes mellitus and COVID-19. More specific markers of the acute kidney injury functional stage were determined;these markers will improve the diagnostics accuracy and validity, therapy efficiency, and end points of disease prognosis. © 2023, Media Sphera Publishing Group. All rights reserved.

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COVID-19肾损伤机制及诊断方法

COVID-19大流行是一场全球卫生保健危机。COVID-19患者急性肾损伤(AKI)的发生率及其诊断特点表明了该主题的相关性。回顾的目的。分析新冠肺炎患者AKI发生机制，为及时诊断提供方法学支持。材料和方法。本综述中使用的方法学方法基于足够数量的文献来源(超过150个来源)，其中34篇文章被纳入本综述:15篇原始研究，12篇综述，2篇荟萃分析，5篇报告和致编辑的信函。结果。AKI发生和发展的机制，包括SARS-CoV-2病毒的直接细胞毒性作用、肾血流调节代谢途径的破坏和补体系统。我们还分析了急性呼吸窘迫患者AKI的危险因素:糖尿病、慢性肾损伤、伴NOx生成的动脉高血压，以及eNOS表达作为肾微循环血管舒张的重要因素。分析显示了AKI功能分期诊断中最有前景的方向。这些方法包括血液和尿液中的分子检测方法(原组和代谢组)，它们有助于确定近端小管和肾小球系统的损伤标记，从而提高诊断的准确性和有效性、治疗效率和疾病预后的终点。结论。Coronado研究旨在评估糖尿病和COVID-19患者的表型特征。确定更特异性的急性肾损伤功能分期标志物，这些标志物将提高诊断的准确性和有效性、治疗效率以及疾病预后的终点。©2023,Media Sphera出版集团。版权所有。

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来源期刊

Profilakticheskaya Meditsina Medicine-Health Policy

CiteScore

0.90

自引率

0.00%

发文量

108

期刊介绍： The journal "Profilakticheskaya meditsina" (The Russian Journal of Preventive Medicine and Public Health) has been published since 1997 and is intended for healthcare professionals and administrators, politicians, and scientists. A wide range of problems appearing on the pages of the journal is determined by its sociopolitical and scientific-and-practical orientations. The journal covers the problems of health promotion, the prevention and treatment of communicable and non-communicable diseases, such as cardiovascular and respiratory diseases, cancers, diabetes, injuries, and violent death. The main sections of the journal: Organization of Public Health Prevention of Communicable and Non-Communicable Diseases, Health Promotion: Policy and Strategy Sociomedical Aspects of Health Formation Medico-Demographic Aspects of Health Formation Prevention of Communicable and Non-Communicable Diseases Risk Factors for Communicable and Non-Communicable Diseases The Health of Children, Adolescents, and Young People Female Health Male Health Nutrition and Health Smoking and Health Alcohol and Health Guidelines for the Specialist Education Programs for Healthcare Specialists and Patients Experience of Regions A Specialist’s Opinion Reviews.