SARS-CoV-2 ile İlişkili Akut Böbrek Hasarı

2019 yılının sonunda Çin'de patlak veren yeni tip koronavirüs (COVID-19) çok kısa sürede küresel bir salgın halini aldı.COVID-19 infeksiyonu esas olarak solunum sistemini etkilemekle birlikte, şiddetli akciğer tutulumu olan olgularda ileriyaş, diyabet, hipertansiyon, kardiyovasküler hastalık, kronik böbrek hastalığı (KBH) gibi yüksek risk grubundakihastalarda böbrek tutulumu sık görülmektedir. Akut böbrek hasarı (ABH), COVID-19 infeksiyonunun majörkomplikasyonlarından biridir, KBH olanlarda daha sık görülmektedir ve artmış morbidite ve mortalite ile ilişkilidir. ABHgelişen olgularda kalıcı böbrek hasarı riski artmıştır. Özellikle COVID-19 infeksiyonu sırasında böbrek fonksiyonlarınındikkatle kontrol edilmesi ve süreç içinde yakın izlem gerektiği, halen etkin bir tedavisi olmayan bu pandemik infeksiyoniçin yaşamsal önemdedir. Bu derlemede COVID-19 seyri sırasında gelişebilecek böbrek tutulumu ve akut böbrek hasarıtartışılmıştır.

Acute Kidney Injury Associated with SARS-CoV-2

The novel coronavirus (COVID-19), which erupted in China at the end of 2019, resulted in a global outbreak in a very short time. Although COVID-19 infection mainly affects the respiratory system, renal impairment is common in patients with severe lung involvement and in patients at high risk groups, such as advanced age, diabetes mellitus, hypertension, cardiovascular disease, and chronic kidney disease (CKD). Acute kidney injury (AKI) is one of the major complications of COVID-19 infection and more common in people with CKD which is associated with increased morbidity and mortality. The risk of permanent kidney damage is increased in cases with AKI. It is very important to check and closely monitoring renal functions among this pandemic COVID-19 infection, does not have an absolute treatment. In this review, kidney involvement and acute kidney injury that may develop during the course of COVID-19 are discussed.

PDF

___

1. deWit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: Recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016; 14: 523-34.
2. Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan China: The mystery and themiracle. J Med Virol. 2020; 92: 401-2.
3. Hui DS, Azhar IE, Madani TA, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health –The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020; 91: 264-6.
4. World Health Organization DirectorGeneral’s opening remarks at the media briefing on COVID-19. WHO; 3 March 2020.
5. Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2020; 24; 8: e35. eCollection 2020.
6. Zhao X, Zhang B, Li P, et al. Incidence, clinical characteristic and prognostic factor of patients with COVID-19: a systematic review and metaanalysis. medRxiv. 2020. doi: https://doi.org/10.1101/2020.03.17.2003757 2
7. Lotfi B, Farshid S, Dadashzadeh N, Valizadeh R, Rahimi MM. Is Coronavirus Disease 2019 (COVID-19) Associated with Renal Involvement? A Review of Century Infection, Jundishapur J Microbiol. 2020; 13: e102899. doi: 10.5812/jjm.102899.
8. Ji Y, Ma Z, Peppelenbosch MP, Pan Q. Potential association between COVID-19 mortality and health-care resource availability. Lancet Glob Health. 2020; 8. e480. doi: 10.1016/S2214- 109X(20)30068-1.
9. Chu KH, Tsang WK, Tang CS, et al. Acute renal impairment in coronavirus-associated severe acute respiratory syndrome. Kidney Int. 2005; 67: 698-705.
10. Koza Y. Acute kidney injury: current concepts and new insights. J Inj Violence Res. 2016; 8: 58-62.
11. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395: 497–506.
12. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395: 507–13.
13. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323: 1061-9.
14. Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020; 97: 829–38.
15. Shi S, Qin M, Shen B, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020 Mar 25. doi: 10.1001/jamacardio.2020.0950.
16. Wang D, Yin Y, Hu C, et al. Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. Crit Care. 2020; 24: 188. doi: 10.1186/s13054-020-02895-6.
17. Wang L, Li X, Chen H, et al. Coronavirus Disease 19 Infection. Does Not Result in Acute Kidney Injury: An Analysis of 116 Hospitalized Patients from Wuhan, China. Am J Nephrol. 2020; 51: 343-8.
18. Li Z, Wu M, Yao J, et al. Caution on kidney dysfunctions of 2019-nCoV patients. medRxiv. 2020. doi: 10.1101/2020.02.08.20021212.
19. Naicker S, Yang CW, Hwang SJ, Liu BC, Chen JH, Jha V. The Novel coronavirus 2019 epidemic and kidneys. Kidney Int. 2020; 97: 824-8.
20. Hong Xw, Chi Zp, Liu Gy, et al. Analysis of early renal injury in COVID-19 and diagnostic value of multi-index combined detection. MedRxiv. 2020.doi: 10.1101/2020.03.07.20032599.
21. Liu R, Ma Q, Han H, et al. The value of urine biochemical parameters in the prediction of the severity of coronavirus disease 2019. Clin Chem Lab Med. 2020 Apr 14. pii: /j/cclm.ahead-ofprint/cclm-2020-0220/cclm-2020-0220.xml. doi: 10.1515/cclm-2020-0220.
22. Peiris JSM, Chu CM, Cheng VCC, et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet. 2003; 361: 1767-72.
23. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395: 497-506.
24. Perico L, Benigni A, Remuzzi G. Should COVID-19 Concern Nephrologists? Why and to What Extent? The Emerging Impasse of Angiotensin Blockade. Nephron. 2020; 144: 213-21.
25. Yalameha B, Roshan B, Bhaskar LVKS, Mohmoodnia L. Perspectives on the relationship of renal disease and coronavirus disease 2019. J Nephropharmacol. 2020; 9: 1-5.
26. Pan XW, Xu D, Zhang H, Zhou W, Wang LH, Cui XG. Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis. Intensive Care Med. 2020; 1‐3.
27. Moeinzadeh F, Dezfouli M, Naimi A, Shahidi S, Moradi H. Newly Diagnosed Glomerulonephritis During COVID-19 Infection Undergoing Immunosuppression Therapy, a Case Report. Iran J Kidney Dis. 2020; 14: 239‐ 42.
28. Diao B, Feng Z, Wang C, et al. Human kidney is a target for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. medRxiv. 2020 Mar; 2020.03.04.20031120.
29. Huang KJ, Su IJ, Theron M, et al. An interferon-gamma-related cytokine storm in SARS patients. JMedVirol. 2005; 75: 185-94.
30. Perazella MA, Shirali AC. Nephrotoxicity of Cancer Immunotherapies: Past, Present and Future. J Am Soc Nephrol. 2018; 29: 2039-52.
31. Ng JJ, Luo Y, Phua K, Choong AMTL. Acute kidney injury in hospitalized patients with coronavirus disease 2019 (COVID-19): Metaanalysis. J Infect. 2020:S0163-4453(20)30280- 2.
32. Iyer M, Jayaramayya K, Subramaniam MD, et al. COVID-19: an update on diagnostic and therapeutic approaches. BMB Rep. 2020; 53: 191-205.
33. Xie C, Jiang L, Huang G, et al. Comparison of different samples for 2019 novel coronavirus detection by nucleic acid amplification tests. Int J Infect Dis. 2020; 93: 264-7.
34. Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020; 14: 72-3.
35. Geleris J, Sun Y, Platt J, et al. Observational Study of Hydroxychloroquine in Hospitalized Patients With Covid-19. N Engl J Med. 2020;NEJMoa2012410. doi: 10.1056/NEJMoa2012410.
36. Vincent MJ, Bergeron E, Benjannet S, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005; 2: 69.
37. Multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za Zhi. 2020; 43: 185‐ 188. doi:10.3760/cma.j.issn.1001- 0939.2020.03.009.
38. Kuba K, Imai Y, Rao S, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med. 2005; 118: 875–9.
39. Gu H, Xie Z, Li T, et al. Angiotensinconvertingenzyme 2 inhibits lung injury induced by respiratory syncytial virus. Sci Rep. 2016; 6: 19840.
40. ESH Statement on COVID-19 |EuropeanSociety of Hypertension [Internet] [cited 2020 Mar 13]. Available from: https://www.eshonline.org/spotlights/eshstatement-on-covid-19/
41. Zhang P, Zhu L, Cai J, et al. Association of Inpatient Use of Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Mortality Among Patients With Hypertension Hospitalized With COVID-19 [published online ahead of print, 2020 Apr 17]. Circ Res. 2020;10.1161/CIRCRESAHA.120.317134. doi:10.1161/CIRCRESAHA.120.317134
42. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020; 181: 271- 80.
43. Fu B, Xu X, Wei H. Why tocilizumab could be an effective treatment for severe COVID-19? J Transl Med. 2020; 18: 164. Published 2020 Apr 14. doi:10.1186/s12967-020-02339-3