Title:COVID-19 and Renal Diseases: An Update
VOLUME: 22 ISSUE: 1
Author(s):Letícia Bitencourt, Ana Luisa Pedrosa, Stephanie Bruna Camilo Soares de Brito, Ana Cláudia Fontoura Fróes, Sarah Tayná de Carvalho, Giulio Gori Fonseca, Guilherme Costa Ferreira, Pollyanna Faria Fradico and Ana Cristina Simões e Silva*
Affiliation:Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais
Keywords:SARS-CoV-2, COVID-19, chronic kidney disease, renal transplantation, acute kidney injury, renal dysfunction.
Abstract:Background: It becomes increasingly evident that the SARS-CoV-2 infection is not
limited to the respiratory system. In addition to being a target of the virus, the kidney also seems to
have a substantial influence on the outcomes of the disease.
Methods: Data was obtained by a comprehensive and non-systematic search in the PubMed,
Cochrane, Scopus and SciELO databases, using mainly the terms “SARS-CoV-2”, “COVID-19”,
“chronic kidney disease”, “renal transplantation”, acute kidney injury” and “renal dysfunction”
Discussion: The membrane-bound angiotensin-converting enzyme 2 is the receptor for SARS-CoV-
-2, and this interaction may lead to an imbalance of the Renin-Angiotensin System (RAS), associated
with worse clinical presentations of COVID-19, including acute pulmonary injury, hyperinflammatory
state and hematological alterations. In the framework of renal diseases, the development of
acute kidney injury is associated mostly with immune alterations and direct cytopathic lesions by
the virus, leading to higher mortality. As for chronic kidney disease, the patients at a non-terminal
stage have a worse prognosis, while the hemodialysis patients appear to have mild courses of
COVID-19, probably due to lower chances of being affected by the cytokine storm. Furthermore,
the current scenario is unfavorable to kidney donation and transplantation. The relationship between
COVID-19 and immunosuppression in kidney transplantation recipients has been greatly discussed
to determine whether it increases mortality and how it interacts with immunosuppressive
medications.
Conclusion: The kidney and the RAS exert fundamental roles in the SARS-CoV-2 infection, and
more research is required to have a complete understanding of the repercussions caused by
COVID-19 in renal diseases.
