COVID-19急性肾损伤的多学科基础和临床研究:病理生理、机制、发病率、治疗和肾移植。

Mohamed Wishahi, Nabawya M Kamal
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引用次数: 6

摘要

与2019冠状病毒病(COVID-19)相关的急性肾损伤(AKI)已在疾病过程中被确定。AKI可分为轻度或重度,这取决于是否存在合并症和COVID-19的严重程度。在因COVID-19住院的患者中,一些人住进了重症监护病房。与COVID-19相关的AKI病因是多因素的。预防严重AKI是COVID-19患者的首要任务,需要在管理中采取一系列措施和预防措施。需要透析的AKI患者发生慢性肾脏疾病(CKD)或其现有CKD进展的风险增加。COVID-19肾移植患者需要特殊管理,调整免疫抑制药物和皮质类固醇的剂量,以防止移植排斥反应,但不能抑制免疫系统,使患者面临COVID-19感染的风险。肾移植患者的免疫抑制药物和皮质类固醇必须根据实验室结果进行调整,并针对保护移植者免受排斥进行个体化治疗。
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Multidisciplinary basic and clinical research of acute kidney injury with COVID-19: Pathophysiology, mechanisms, incidence, management and kidney transplantation.

Acute kidney injury (AKI) linked to coronavirus disease 2019 (COVID-19) has been identified in the course of the disease. AKI can be mild or severe and that is dependent on the presence of comorbidities and the severity of COVID-19. Among patients who had been hospitalized with COVID-19, some were admitted to intensive care unit. The etiology of AKI associated with COVID-19 is multifactorial. Prevention of severe AKI is the prime task in patients with COVID-19 that necessitates a battery of measurements and precautions in management. Patients with AKI who have needed dialysis are in an increased risk to develop chronic kidney disease (CKD) or a progression of their existing CKD. Kidney transplantation patients with COVID-19 are in need of special management to adjust the doses of immunosuppression drugs and corticosteroids to guard against graft rejection but not to suppress the immune system to place the patient at risk of developing a COVID-19 infection. Immunosuppression drugs and corticosteroids for patients who have had a kidney transplant has to be adjusted based on laboratory results and is individualized aiming at the protection of the transplanted from rejection.

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