genitourinary disorders
COVID 19 and Acute Kidney Injury (AKI)
Introduction
COVID-19, a disease caused by the novel coronavirus SARS-CoV-2, may present with acute kidney injury (AKI), particularly in critically ill patients. (See also Acute Kidney Injury (AKI) and The presence of AKI increases risk of mortality in patients with COVID-19 ( General references ). In a recent systematic review and meta-analysis, the incidence of AKI was 17%, although it varied from 0.5 to 80% among individual studies depending on geographic location and number of critically ill patients. In this meta-analysis, the overall mortality was 11% and AKI increased the risk of death; utilization of renal replacement therapy was 5% overall ( While the data are new and evolving, the following have been described as independent risk factors for AKI with COVID-19 ( General references ) thus far: Age Race (higher among Black people) Diabetes Obesity Hypertension Cardiovascular disease Low baseline kidney function Mechanical ventilation Shock requiring vasopressors Early studies suggest that the pathophysiology of AKI may be due to ischemia during Sepsis and Septic Shock , systemic inflammatory response to the virus, and potentially direct viral toxicity to the kidneys. Kidney histopathology most commonly shows Presentation of AKI in patients with COVID-19 is similar to that of other infectious etiologies, including elevated creatinine, oliguria or anuria, and in some cases proteinuria (including nephrotic range) and hematuria ( General references ). Treatment is focused on supportive care, including intravascular volume optimization (balanced against the risk of pulmonary edema in patients with respiratory distress), monitoring of electrolytes, and possibly 