COVID-19 caused by the coronavirus has led to the global pandemic for a long time. Doctors and researchers found its damage to the lungs in previous research, while more infections are showing that the coronavirus also results in severe and lasting damage to other organs, including the heart and kidneys. This page discusses how the new coronavirus may provoke kidney diseases and causes damage to the kidney functions as disease development and recovery.

Starting from a Real Case

A normally fit 17-year-old male presented to have a 2-day history of vomiting and nausea with continuous bilateral loin to groin pains was first diagnosed as a significant acute kidney injury (AKI). However, the COVID-19 test of this patient appeared to be positive the next morning, and later the male developed a myocardial injury and Type 1 respiratory failure during the admission.

The symptoms, biomarkers of acute kidney injury, and the presentation of the patient indicated that AKI apparently preceded the myocardial injury. The complexity of this real case demonstrates the multiorgan effects of COVID-19, including cardiovascular, pulmonary, renal, dermatologic, neurologic, and psychiatric.

Kidney Damage: A Possible Complication of COVID-19

Up to 30% of patients hospitalized with COVID-19 in China and New York are reported to develop moderate or severe kidney injury. But doctors from in New York introduce that the percentage is expected to be higher.

Kidney damage includes a high level of proteins in the urine and the abnormal result of a blood test, though the patients did not have any kidney problems before the coronavirus infection. COVID-19 patients with co-existing, chronic conditions like high blood pressure and diabetes have an increased risk of kidney diseases.

How COVID-19 May Damage the Kidneys?

The impact of COVID-19 on the kidneys is not fully understood, but researchers do explorers some possibilities.

l Coronavirus targets kidney cells

A surmise is that kidney cells have new coronavirus receptors, allowing the viruses to attach, invade, self-copy, and damage those tissues. This concept is possible because similar receptors are found on lungs and heart cells to cause different levels of injury.

l Lack of oxygen causes kidneys malfunction

This is persuasive in that severe pneumonia cases often are detected with abnormally low levels of oxygen in the blood.

l Excessive immune response

An over-active immune response to the new coronavirus infection may lead to a cytokine storm, in which a large influx of cytokines is generated and causes a severe inflammatory reaction that may damage healthy kidney tissues.

Diagnosis of Acute Kidney Injury

Biomarkers of kidney diseases play an important role in accurate diagnosis, assessing risk, and adopting clinical therapy outcomes. Biomarkers can be proteins, lipids, microRNAs, genes, metabolites, proteomic patterns, or cells present on a urinalysis.

For instance, measurement of the glomerular filtration rate (GFR) is necessary for the diagnosis of chronic kidney diseases, which is accomplished by key biomarkers such as blood urea nitrogen (BUN), creatinine antibody, urinary albumin/protein, and volume excretion. Besides the biomarkers of GFR that are applied to the current diagnosis of AKI, research has also defined better and more new biomarkers to improve the treatment outcomes.

Once the condition is confirmed, patients with COVID-19-related kidney damage are advised to monitor kidney normal functions even after recovery from COVID-19. Lasting kidney damage might require dialysis or other therapies.