Department of Medicine, Johns Hopkins School of Medicine, 5601 Loch Raven Boulevard, Suite 3 North, Baltimore, MD, 21205, USA.
Nephrology Center of Maryland, Baltimore, MD, USA.
BMC Nephrol. 2020 Oct 27;21(1):449. doi: 10.1186/s12882-020-02112-0.
The pandemic of coronavirus disease 2019 (CoVID-19) has been an unprecedented period. The disease afflicts multiple organ systems, with acute kidney injury (AKI) a major complication in seriously ill patients. The incidence of AKI in patients with CoVID-19 is variable across numerous international studies, but the high incidence of AKI and its associated worse outcomes in the critical care setting are a consistent finding. A multitude of patterns and mechanisms of AKI have been elucidated, and novel strategies to address shortage of renal replacement therapy equipment have been implemented. The disease also has had consequences on longitudinal management of patients with chronic kidney disease and end stage kidney disease. Kidney transplant recipients may be especially susceptible to CoVID-19 as a result of immunosuppression, with preliminary studies demonstrating high mortality rates. Increased surveillance of disease with low threshold for testing and adjustment of immunosuppression regimen during acute periods of illness have been recommended.
2019 年冠状病毒病（COVID-19）大流行是一段前所未有的时期。该疾病影响多个器官系统，急性肾损伤（AKI）是重症患者的主要并发症。多项国际研究中 COVID-19 患者 AKI 的发病率不同，但 AKI 的高发病率及其在重症监护环境下相关的不良预后是一致的发现。已经阐明了 AKI 的多种模式和机制，并实施了新的策略来解决肾脏替代治疗设备短缺的问题。该疾病也对慢性肾脏病和终末期肾病患者的长期管理产生了影响。由于免疫抑制，肾移植受者可能特别容易感染 COVID-19，初步研究表明死亡率很高。建议增加疾病监测，降低检测阈值，并在疾病急性期间调整免疫抑制方案。
