Multidisciplinary basic and clinical research of acute kidney injury with COVID-19: Pathophysiology, mechanisms, incidence, management and kidney transplantation

doi:10.5527/wjn.v11.i3.105

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World Journal of Nephrology

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World J Nephrol. May 25, 2022; 11(3): 105-114
Published online May 25, 2022. doi: 10.5527/wjn.v11.i3.105

Multidisciplinary basic and clinical research of acute kidney injury with COVID-19: Pathophysiology, mechanisms, incidence, management and kidney transplantation

Mohamed Wishahi, Nabawya M Kamal

Mohamed Wishahi, Department of Urology, Theodor Bilharz Research Institute, Cairo 12411, Egypt

Nabawya M Kamal, Department of Anaesthesia and Surgical Intensive Care, Theodor Bilharz Research Institute, Cairo 12411, Egypt

Author contributions: Wishahi M and Nabawya M Kamal contributed equally to this work, designed the research study, performed the research, analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.

Conflict-of-interest statement: Mohamed Wishahi and Nabawya M Kamal have nothing to declare and they did not receive fees for serving as a speaker or position such as consultant and/or an advisory board member, or for an organization(s). They have not received research funding from any individual or an organization.

Corresponding author: Mohamed Wishahi, MD, PhD, Doctor, Professor, Department of Urology, Theodor Bilharz Research Institute, Embaba, Giza, Cairo 12411, Egypt. moh.weshahy@gmail.com

Received: January 8, 2022
Peer-review started: January 8, 2022
First decision: February 21, 2022
Revised: March 4, 2022
Accepted: April 30, 2022
Article in press: April 30, 2022
Published online: May 25, 2022
Processing time: 135 Days and 13.8 Hours

Core Tip

Core Tip: Acute kidney injury (AKI) in patients with coronavirus disease 2019 (COVID-19) is initiated by multifactorial events including direct viral effect, cardiac causes, thromboembolic phenomenon and cytokine storm. AKI is attributed to collapsing glomerulopathy, acute tubular necrosis and mitochondrial dysfunction. Management of AKI is multidisciplinary dependent on severity of COVID-19, associated comorbidities, intensive care unit admission and artificial ventilation. Management is initial control of fluid balance and in severe cases an early initiation of renal replacement and extracorporeal organ support which would support the organs and prevent disease progression. Kidney transplantation patients are at risk of developing AKI due to the state of their immunocompromised status caused by regular use of immunosuppressants; this situation indicates the adjustment of immunosuppressors in the condition of treatment of cytokine storm with corticosteroids.