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Post Cov-19 kidney complications

Approximately 10-50% of the COVID-19 patients in ICU have kidney failure.

When COVID-19 pandemic struck the world, most people thought that it is a normal respiratory virus with high contagious nature. However, as the days are passing by and with the rising cases and death tolls, this virus has proven everybody wrong because of its severity and complications even after the recovery.

Patients are at risk of long-term complications after recovery from COVID-19. One such complication is Acute Kidney Injury (AKI) and Acute Kidney Failure (AKF). The kidney damage is significant in COVID-19 patients who are hospitalized (8-22%). “Even in our hospital a significant proportion of 5-10% of patients reported with AKI and AKF during COVID and post COVID recovery phase and needing intervention in the form of medication and kidney biopsy” added Dr. Vishwanath S

Acute kidney injury also increases morbidity and mortality in COVID-19 patients. The kidney damage may progress to kidney failure in these patients without adequate medical attention. Many patients with COVID-19 related to acute kidney injury may experience a reduction in kidney function after recovery from the infection. Some patients may require dialysis throughout their life.

CAUSES OF POST COVID-19 KIDNEY FAILURE

The cause of kidney failure after the COVID-19 infection is multifactorial. The degree of kidney damage and the risk of kidney failure depend upon various factors, including the severity of the infection and underlying medical conditions.

The viral infection may attack the kidney directly or indirectly. The direct impact may include glomerulopathy (Kidney filter involvement), inflammation (Swelling), coagulopathy (bleeding & clotting of blood inside the kidney), and endothelial damage (blood vessel damage). Damage to the kidney may also be due to indirect impacts such as poor blood supply to the kidneys, blood clots infection and a hyperactive immune system. Though these kidney problems can occur in anyone with a history of COVID 19, patients with previous history of kidney diseases are at higher risk. Elderly patients, patients with diabetes and hypertension, congestive heart failure, and smoking history are also at increased risk for developing COVID-19 related acute kidney injury. The risk further increases if the patient has poor respiratory status, dehydration, and leukocytosis at the time of hospitalization. The most common signs of kidney complications can be recognized through high levels of protein in the urine and abnormal blood tests.

MEASURES TO REDUCE THE RISK OF POST COVID-19 KIDNEY FAILURE

The first step in preventing kidney failure in post-COVID-19 patients is to avoid the progression of acute kidney injury.

Early recognition and timely intervention will allow Acute Kidney Injury to recover quickly and also won't allow the kidney to develop Chronic Kidney Disease (CKD). Acute kidney injury is a reversible condition and can be effectively managed with medication and dialysis, if needed. Such patients should have a routine check-up of kidney function. The doctor should also prepare strategies for treating COVID-19 in such a way as to reduce the risk of acute kidney failure in high-risk patients. It may include avoiding drugs that cause nephrotoxicity, management of blood glucose, expansion of intravascular volume through fluid management, and monitoring the kidney function.


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