Acute Kidney Injury and Kidney Damage in COVID-19 Patients

J Korean Med Sci. 2020 Jul 20;35(28):e257. doi: 10.3346/jkms.2020.35.e257.

Abstract

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This disease, which is quickly spreading worldwide, has high potential for infection and causes rapid progression of lung lesions, resulting in a high mortality rate. This study aimed to investigate the effects of SARS-CoV-2 infection on renal function in patients with COVID-19.

Methods: From February 21 to April 24, 2020, 66 patients diagnosed with COVID-19 at Chungnam National University Hospital were analyzed; all patients underwent routine urinalysis and were tested for serum creatinine, urine protein to creatinine ratio (PCR), and urine albumin to creatinine ratio (ACR).

Results: Acute kidney injury (AKI) occurred in 3 (4.5%) of the 66 patients, and 1 patient with AKI stage 3 underwent hemodialysis. Upon follow-up, all 3 patients recovered normal renal function. Compared with patients with mild COVID-19, AKI (n = 3) occurred in patients with severe COVID-19, of whom both urine PCR and ACR were markedly increased.

Conclusion: The incidence of AKI was not high in COVID-19 patients. The lower mortality rate in SARS-CoV-2 infection compared with previous Middle East respiratory syndrome and SARS-CoV infections is thought to be associated with a low incidence of dysfunction in organs other than the lungs.

Keywords: Acute Kidney Injury; COVID-19; Coronavirus Disease 2019; Proteinuria; SARS-CoV-2; Severe Acute Respiratory Syndrome Coronavirus 2.

MeSH terms

  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / pathology
  • Acute Kidney Injury / virology*
  • Aged
  • Albumins / analysis
  • Albuminuria / urine*
  • Betacoronavirus
  • Coronavirus Infections / pathology*
  • Creatinine / blood*
  • Female
  • Glomerular Filtration Rate / physiology
  • Humans
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / pathology*
  • Proteinuria / urine*
  • Republic of Korea / epidemiology

Substances

  • Albumins
  • Creatinine

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2