Mayerhöfer Timo, Perschinka Fabian, Joannidis Michael
Gemeinsame Einrichtung für Internistische Intensiv- und Notfallmedizin, Department, Innere Medizin, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
Med Klin Intensivmed Notfmed. 2022 Jun;117(5):342-348. doi: 10.1007/s00063-022-00919-3. Epub 2022 Apr 27.
Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) is common in critically ill patients. Renal tropism of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) appears to play only a minor role, whereas the pathological inflammatory response associated with severe COVID-19 is highly relevant. Both the consequences of invasive ventilation and acute respiratory distress syndrome (ARDS) caused by COVID-19 have a significant impact on the pathogenesis of AKI. High ventilation pressures compromise renal perfusion and, thus, may contribute to the development of AKI. The inflammatory response caused by ARDS, as well as the endothelial dysfunction typical of COVID-19 in combination with hypercoagulability are further factors that affect the kidney.
2019冠状病毒病(COVID-19)相关的急性肾损伤(AKI)在重症患者中很常见。严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)的肾脏嗜性似乎仅起次要作用,而与重症COVID-19相关的病理性炎症反应则高度相关。COVID-19导致的有创通气和急性呼吸窘迫综合征(ARDS)的后果对AKI的发病机制都有重大影响。高通气压力会损害肾脏灌注,因此可能导致AKI的发生。ARDS引起的炎症反应,以及COVID-19典型的内皮功能障碍与高凝状态相结合,都是影响肾脏的进一步因素。