Division of Nephrology and Hypertension, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Clinical and Experimental Medicine, Faculty of Health Sciences, University of Surrey, Guildford, UK.
Nat Rev Nephrol. 2020 Dec;16(12):747-764. doi: 10.1038/s41581-020-00356-5. Epub 2020 Oct 15.
Kidney involvement in patients with coronavirus disease 2019 (COVID-19) is common, and can range from the presence of proteinuria and haematuria to acute kidney injury (AKI) requiring renal replacement therapy (RRT; also known as kidney replacement therapy). COVID-19-associated AKI (COVID-19 AKI) is associated with high mortality and serves as an independent risk factor for all-cause in-hospital death in patients with COVID-19. The pathophysiology and mechanisms of AKI in patients with COVID-19 have not been fully elucidated and seem to be multifactorial, in keeping with the pathophysiology of AKI in other patients who are critically ill. Little is known about the prevention and management of COVID-19 AKI. The emergence of regional 'surges' in COVID-19 cases can limit hospital resources, including dialysis availability and supplies; thus, careful daily assessment of available resources is needed. In this Consensus Statement, the Acute Disease Quality Initiative provides recommendations for the diagnosis, prevention and management of COVID-19 AKI based on current literature. We also make recommendations for areas of future research, which are aimed at improving understanding of the underlying processes and improving outcomes for patients with COVID-19 AKI.
新型冠状病毒病 2019（COVID-19）患者的肾脏受累很常见，其表现范围从蛋白尿和血尿到需要肾脏替代治疗（RRT；也称为肾脏替代治疗）的急性肾损伤（AKI）。COVID-19 相关 AKI（COVID-19 AKI）与高死亡率相关，并且是 COVID-19 患者全因院内死亡的独立危险因素。COVID-19 患者 AKI 的病理生理学和机制尚未完全阐明，似乎与其他危重症患者 AKI 的病理生理学相似，原因多种多样。关于 COVID-19 AKI 的预防和管理知之甚少。COVID-19 病例的区域性“激增”会限制医院资源，包括透析的可用性和供应；因此，需要仔细每天评估可用资源。在本共识声明中，急性疾病质量倡议根据当前文献为 COVID-19 AKI 的诊断、预防和管理提供了建议。我们还为未来的研究领域提出了建议，旨在增进对潜在过程的理解并改善 COVID-19 AKI 患者的预后。
