Sharma Purva, Ng Jia H, Bijol Vanesa, Jhaveri Kenar D, Wanchoo Rimda
Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park, NY, USA.
Glomerular Center at Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park, NY, USA.
Clin Kidney J. 2021 Jan 24;14(Suppl 1):i30-i39. doi: 10.1093/ckj/sfab003. eCollection 2021 Mar.
Acute kidney injury (AKI) is common among hospitalized patients with coronavirus disease 2019 (COVID-19), with the occurrence of AKI ranging from 0.5% to 80%. An improved knowledge of the pathology of AKI in COVID-19 is crucial to mitigate and manage AKI and to improve the survival of patients who develop AKI during COVID-19. In this review, we summarize the published cases and case series of various kidney pathologies seen with COVID-19. Both live kidney biopsies and autopsy series suggest acute tubular injury as the most commonly encountered pathology. Collapsing glomerulopathy and thrombotic microangiopathy are other encountered pathologies noted in both live and autopsy tissues. Other rare findings such as anti-neutrophil cytoplasmic antibody vasculitis, anti-glomerular basement membrane disease and podocytopathies have been reported. Although direct viral infection of the kidney is possible, it is certainly not a common or even widespread finding reported at the time of this writing (November 2020).
急性肾损伤（AKI）在2019冠状病毒病（COVID-19）住院患者中很常见，AKI的发生率在0.5%至80%之间。深入了解COVID-19患者AKI的病理情况对于减轻和管理AKI以及提高COVID-19期间发生AKI患者的生存率至关重要。在本综述中，我们总结了已发表的COVID-19患者出现的各种肾脏病理情况的病例和病例系列。肾活检和尸检系列均提示急性肾小管损伤是最常见的病理表现。塌陷性肾小球病和血栓性微血管病是在肾活检和尸检组织中发现的其他病理情况。也有报告称存在其他罕见发现，如抗中性粒细胞胞浆抗体血管炎、抗肾小球基底膜病和足细胞病。虽然肾脏可能受到病毒直接感染，但在撰写本文时（2020年11月），这肯定不是一个常见甚至普遍的发现。
