COVID-19 in nephrologist practice: A review of current knowledge

Objective: To highlight the various aspects of kidney involvement in the context of COVID-19 and focus on the preventive policies that should be considered in vulnerable patients with renal diseases Design: A comprehensive electronic search of the terms relevant to this review to identify the relevant studies Setting: An electronic search was conducted in MEDLINE, PubMed, ISI Web of Science and Scopus scientific databases. We also searched the conference proceedings and clinicaltrials.gov database. Subjects: Articles focusing on COVID-19 and kidney diseases, published up to July 2020 Interventions: Retrieved articles were subtly studied. Data obtained included the mutual relationship between the virus and kidney diseases. Main outcome measures: The impact of COVID-19 on the kidney and the vulnerability of patients with pre-existing kidney diseases were analyzed, with special focus on prevention. Results: The pathogenesis of kidney injury in the setting of COVID-19 is largely explained by two main theories; either direct renal cellular injury or systemic viral effects. Acute kidney injury is frequently reported in patients with severe COVID-19 disease. Glomerulopathies have been reported as well. Patients with pre-existing kidney diseases experienced more severe disease. Several preventive strategies are proposed. Conclusion: Evidence is growing that kidneys are a potential target for COVID-19. COVID-19 has been found to impair the kidney function in several ways. On the other hand, patients with preexisting kidney disease, those on long-term renal replacement therapy and recipients of kidney transplant are particularly vulnerable to infection and accordingly at risk for fatal morbidity and mortality.