COVID-19 and chronic kidney disease: a comprehensive review.
Inah Maria D PeclyRafael Bellotti AzevedoElizabeth Silaid MuxfeldtBruna Gopp BotelhoGabriela G AlbuquerquePedro Henrique P DinizRodrigo SilvaCibele Isaac Saad RodriguesPublished in: Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia (2021)
Kidney impairment in hospitalized patients with SARS-CoV-2 infection is associated with increased in-hospital mortality and worse clinical evolution, raising concerns towards patients with chronic kidney disease (CKD). From a pathophysiological perspective, COVID-19 is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha), causing systemic inflammation and hypercoagulability, and multiple organ dysfunction syndrome. Emerging data postulate that CKD under conservative treatment or renal replacement therapy (RRT) is an important risk factor for disease severity and higher in-hospital mortality amongst patients with COVID-19. Regarding RAAS blockers therapy during the pandemic, the initial assumption of a potential increase and deleterious impact in infectivity, disease severity, and mortality was not evidenced in medical literature. Moreover, the challenge of implementing social distancing in patients requiring dialysis during the pandemic prompted national and international societies to publish recommendations regarding the adoption of safety measures to reduce transmission risk and optimize dialysis treatment during the COVID-19 pandemic. Current data convey that kidney transplant recipients are more vulnerable to more severe infection. Thus, we provide a comprehensive review of the clinical outcomes and prognosis of patients with CKD under conservative treatment and dialysis, and kidney transplant recipients and COVID-19 infection.
Keyphrases
- chronic kidney disease
- end stage renal disease
- coronavirus disease
- sars cov
- peritoneal dialysis
- healthcare
- electronic health record
- quality improvement
- rheumatoid arthritis
- stem cells
- oxidative stress
- cardiovascular disease
- climate change
- risk assessment
- mental health
- combination therapy
- early onset
- cardiovascular events
- big data
- drug induced
- human health
- mesenchymal stem cells
- artificial intelligence