Amann K, Boor P, Wiech T, Singh J, Vonbrunn E, Knöll A, Hermann M, Büttner-Herold M, Daniel C, Hartmann A
Abt. Nephropathologie, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland.
Institut für Pathologie & Medizinische Klinik II (Nephrologie), Sektion Translationale Nephropathologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland.
Pathologe. 2021 Mar;42(2):183-187. doi: 10.1007/s00292-020-00899-1. Epub 2021 Feb 1.
Apart from pulmonary disease, acute kidney injury (AKI) is one of the most frequent and most severe organ complications in severe coronavirus disease 2019 (COVID-19). The SARS-CoV‑2 virus has been detected in renal tissue. Patients with chronic kidney disease (CKD) before and on dialysis and specifically renal transplant patients represent a particularly vulnerable population. The increasing number of COVID-19 infected patients with renal involvement led to an evolving interest in the analysis of its pathophysiology, morphology and modes of virus detection in the kidney. Meanwhile, there are ample data from several autopsy and kidney biopsy studies that differ in the quantity of cases as well as in their quality. While the detection of SARS-CoV‑2 RNA in the kidney leads to reproducible results, the use of electron microscopy for visualisation of the virus is difficult and currently critically discussed due to various artefacts. The exact contribution of indirect or direct effects on the kidney in COVID-19 are not yet known and are currently the focus of intensive research.
除肺部疾病外，急性肾损伤（AKI）是重症2019冠状病毒病（COVID-19）最常见、最严重的器官并发症之一。在肾组织中已检测到严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒。透析前患有慢性肾脏病（CKD）的患者，尤其是肾移植患者，是特别脆弱的人群。COVID-19感染且有肾脏受累的患者数量不断增加，这使得人们对其肾脏病理生理学、形态学及病毒检测方式的分析兴趣日增。与此同时，多项尸检和肾活检研究提供了大量数据，这些研究在病例数量和质量上存在差异。虽然在肾脏中检测SARS-CoV-2 RNA可得到可重复的结果，但由于各种假象，利用电子显微镜观察病毒存在困难，目前对此存在激烈讨论。在COVID-19中，对肾脏的间接或直接影响的确切作用尚不清楚，目前是深入研究的重点。
