J Korean Med Sci.  2020 Jul;35(28):e257. 10.3346/jkms.2020.35.e257.

Acute Kidney Injury and Kidney Damage in COVID-19 Patients

• Na KR
• Kim HR
• Ham Y
• Choi DE
• Lee KW
• Moon JY
• Kim YS
• Cheon S
• Sohn KM
• Kim J
• Kim S
• Jeong H
• Jeon JW

• KMID: 2504367
• DOI: http://doi.org/10.3346/jkms.2020.35.e257

Abstract

Background
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This disease, which is quickly spreading worldwide, has high potential for infection and causes rapid progression of lung lesions, resulting in a high mortality rate. This study aimed to investigate the effects of SARS-CoV-2 infection on renal function in patients with COVID-19.
Methods
From February 21 to April 24, 2020, 66 patients diagnosed with COVID-19 at Chungnam National University Hospital were analyzed; all patients underwent routine urinalysis and were tested for serum creatinine, urine protein to creatinine ratio (PCR), and urine albumin to creatinine ratio (ACR).
Results
Acute kidney injury (AKI) occurred in 3 (4.5%) of the 66 patients, and 1 patient with AKI stage 3 underwent hemodialysis. Upon follow-up, all 3 patients recovered normal renal function. Compared with patients with mild COVID-19, AKI (n = 3) occurred in patients with severe COVID-19, of whom both urine PCR and ACR were markedly increased.
Conclusion
The incidence of AKI was not high in COVID-19 patients. The lower mortality rate in SARS-CoV-2 infection compared with previous Middle East respiratory syndrome and SARS-CoV infections is thought to be associated with a low incidence of dysfunction in organs other than the lungs.

Keyword

Coronavirus Disease 2019; COVID-19; Severe Acute Respiratory Syndrome Coronavirus 2; SARS-CoV-2; Acute Kidney Injury; Proteinuria

Figure

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  Fig. 1 Changes in SCr and clinical events in three patients with acute kidney injury. (A) Sixty-two-year-old-man. (B) Seventy-eight-year-old-woman. (C) Sixty-four-year-old-woman.SCr = serum creatinine, ECMO = extracorporeal membrane oxygenation, CRRT = continuous renal replacement therapy, HD = hemodialysis.

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