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新型冠状病毒肺炎对肾脏系统的影响:病理生理学与临床转归。

COVID-19 impact on the renal system: Pathophysiology and clinical outcomes.

机构信息

Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.

Department of Anesthesiology, LSU Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA, 70112, USA.

出版信息

Best Pract Res Clin Anaesthesiol. 2021 Oct;35(3):449-459. doi: 10.1016/j.bpa.2021.02.004. Epub 2021 Mar 2.

Abstract

Coronavirus disease (COVID-19) causes many deleterious effects throughout the body. Prior studies show that the incidence of acute kidney injury in COVID-19 patients could be as high as 25%. There are also autopsy reports showing evidence of viral tropism to the renal system. In this regard, COVID-19 can damage the kidneys and increase a patient's risk of requiring dialysis. Available evidence suggests that renal involvement in COVID-19 infection is not uncommon, and there has been an increased incidence of chronic kidney disease related to the pandemic. In this literature analysis, we address COVID-19 and its effects on the renal system, including the pathophysiologic mechanisms. We also address current studies on the causes of injury to the renal system, the cause of kidney failure, its effect on mortality, the impact on dialysis patients, and the impact on renal transplant patients. COVID-19 disease may have unique features in individuals on chronic dialysis and kidney transplant recipients, requiring increased vigilance in limiting viral transmission in perioperative, in-patient, and dialysis center settings.

摘要

冠状病毒病(COVID-19)会在全身引起许多有害影响。先前的研究表明,COVID-19 患者发生急性肾损伤的发生率可能高达 25%。也有尸检报告显示病毒对肾脏系统有嗜性的证据。在这方面,COVID-19 会损害肾脏并增加患者需要透析的风险。现有证据表明,COVID-19 感染引起的肾脏受累并不少见,与大流行相关的慢性肾脏病的发病率也有所增加。在本次文献分析中,我们讨论了 COVID-19 及其对肾脏系统的影响,包括病理生理机制。我们还讨论了目前关于肾脏系统损伤的原因、肾衰竭的原因、对死亡率的影响、对透析患者的影响以及对肾移植患者的影响的研究。COVID-19 疾病在慢性透析和肾移植受者个体中可能具有独特的特征,需要在围手术期、住院和透析中心环境中加强警惕,以限制病毒传播。

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