Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Division of Nephrology, Henry Ford Hospital, Detroit, MI.
Adv Chronic Kidney Dis. 2019 May;26(3):207-219. doi: 10.1053/j.ackd.2019.01.006.
Viral infection-associated kidney diseases are an emerging public health issue in both developing and developed countries. Many new viruses have emerged with new paradigms of kidney injury, either directly through their cytopathic effect or indirectly through immune-mediated glomerulopathy, tubulointerstitial disease, and acute kidney injury as part of multiorgan failure. Herein, we will discuss Parvovirus, which causes glomerulopathy, and Hanta, Ebola, and Dengue viruses, which cause viral hemorrhagic fever and acute kidney injury. Clinical manifestations also depend on extrarenal organ systems involved. Diagnosis of these viral infections is mainly based on a high index of suspicion, serologic testing, and isolation of viral DNA/RNA. Management is largely conservative, as specific antiviral agents are unavailable.
病毒感染相关性肾脏疾病是发展中国家和发达国家共同面临的一个新兴公共卫生问题。许多新病毒的出现带来了新的肾脏损伤模式,它们可以直接通过细胞病变作用,也可以通过免疫介导的肾小球病、小管间质性疾病和急性肾损伤作为多器官衰竭的一部分间接引起。在此,我们将讨论引起肾小球病的微小病毒,以及引起病毒性出血热和急性肾损伤的汉坦病毒、埃博拉病毒和登革热病毒。临床表现也取决于受累的肾外器官系统。这些病毒感染的诊断主要基于高度怀疑、血清学检测和病毒 DNA/RNA 的分离。由于缺乏特定的抗病毒药物,治疗主要以保守治疗为主。