Division of Nephrology and Hypertension, 1st Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636, Thessaloniki, Greece.
Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
Int Urol Nephrol. 2022 May;54(5):1053-1057. doi: 10.1007/s11255-021-02976-7. Epub 2021 Aug 12.
Although coronavirus disease (COVID-19) is primarily a respiratory disease, the kidney may be among the target organs of infection with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Independently of baseline kidney function, acute kidney injury (AKI) is a common complication of COVID-19, associated with increased mortality and morbidity. Most frequently, COVID-19 causes acute tubular necrosis; however, in some cases, collapsing focal segmental glomerulosclerosis and direct viral tropism of the kidneys have also been documented. AKI secondary to COVID-19 has a multi-factorial origin. Even mild impairment of renal function is an independent risk factor for COVID-19 infection, hospitalisation and mortality. Dialysis patients also carry an increased risk of other severe COVID-related complications, including arrhythmias, shock, acute respiratory distress syndrome and acute heart failure. In such patients, COVID-19 may even present with atypical clinical symptoms, including gastrointestinal disorders and deterioration of mental status. More research is needed on the exact effects of SARS-CoV-2 on the kidneys. Finally, it remains to be proven whether the outcome of patients with kidney disease may be improved with anticipated vaccination programmes.
虽然冠状病毒病（COVID-19）主要是一种呼吸道疾病，但肾脏可能是严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的靶器官之一。独立于基线肾功能，急性肾损伤（AKI）是 COVID-19 的常见并发症，与死亡率和发病率增加有关。COVID-19 最常引起急性肾小管坏死；然而，在某些情况下，也有记录表明肾小球肾炎伴局灶性节段性肾小球硬化和肾脏的直接病毒趋向性。COVID-19 继发的 AKI 具有多因素起源。即使肾功能轻度受损也是 COVID-19 感染、住院和死亡的独立危险因素。透析患者也有发生其他严重 COVID 相关并发症的风险增加，包括心律失常、休克、急性呼吸窘迫综合征和急性心力衰竭。在这些患者中，COVID-19 甚至可能表现出非典型的临床症状，包括胃肠道疾病和精神状态恶化。需要对 SARS-CoV-2 对肾脏的确切影响进行更多研究。最后，尚需证明肾脏病患者的预后是否可以通过预期的疫苗接种计划得到改善。
