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Kidney Injury in Critically Ill Patients with COVID-19 – From Pathophysiological Mechanisms to a Personalized Therapeutic Model
Acute kidney injury is a common complication of COVID-19, frequently fuelled by a complex interplay of factors. These include tubular injury and three primary drivers of cardiocirculatory instability: heart-lung interaction abnormalities, myocardial damage, and disturbances in fluid balance. Further...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sciendo
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425930/ https://www.ncbi.nlm.nih.gov/pubmed/37588184 http://dx.doi.org/10.2478/jccm-2023-0023 |
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author | Balan, Cosmin Ciuhodaru, Tudor Bubenek-Turconi, Serban-Ion |
author_facet | Balan, Cosmin Ciuhodaru, Tudor Bubenek-Turconi, Serban-Ion |
author_sort | Balan, Cosmin |
collection | PubMed |
description | Acute kidney injury is a common complication of COVID-19, frequently fuelled by a complex interplay of factors. These include tubular injury and three primary drivers of cardiocirculatory instability: heart-lung interaction abnormalities, myocardial damage, and disturbances in fluid balance. Further complicating this dynamic, renal vulnerability to a “second-hit” injury, like a SARS-CoV-2 infection, is heightened by advanced age, chronic kidney disease, cardiovascular diseases, and diabetes mellitus. Moreover, the influence of chronic treatment protocols, which may constrain the compensatory intrarenal hemodynamic mechanisms, warrants equal consideration. COVID-19-associated acute kidney injury not only escalates mortality rates but also significantly affects long-term kidney function recovery, particularly in severe instances. Thus, the imperative lies in developing and applying therapeutic strategies capable of warding off acute kidney injury and decelerating the transition into chronic kidney disease after an acute event. This narrative review aims to proffer a flexible diagnostic and therapeutic strategy that recognizes the multi-faceted nature of COVID-19-associated acute kidney injury in critically ill patients and underlines the crucial role of a tailored, overarching hemodynamic and respiratory framework in managing this complex clinical condition. |
format | Online Article Text |
id | pubmed-10425930 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Sciendo |
record_format | MEDLINE/PubMed |
spelling | pubmed-104259302023-08-16 Kidney Injury in Critically Ill Patients with COVID-19 – From Pathophysiological Mechanisms to a Personalized Therapeutic Model Balan, Cosmin Ciuhodaru, Tudor Bubenek-Turconi, Serban-Ion J Crit Care Med (Targu Mures) Review Acute kidney injury is a common complication of COVID-19, frequently fuelled by a complex interplay of factors. These include tubular injury and three primary drivers of cardiocirculatory instability: heart-lung interaction abnormalities, myocardial damage, and disturbances in fluid balance. Further complicating this dynamic, renal vulnerability to a “second-hit” injury, like a SARS-CoV-2 infection, is heightened by advanced age, chronic kidney disease, cardiovascular diseases, and diabetes mellitus. Moreover, the influence of chronic treatment protocols, which may constrain the compensatory intrarenal hemodynamic mechanisms, warrants equal consideration. COVID-19-associated acute kidney injury not only escalates mortality rates but also significantly affects long-term kidney function recovery, particularly in severe instances. Thus, the imperative lies in developing and applying therapeutic strategies capable of warding off acute kidney injury and decelerating the transition into chronic kidney disease after an acute event. This narrative review aims to proffer a flexible diagnostic and therapeutic strategy that recognizes the multi-faceted nature of COVID-19-associated acute kidney injury in critically ill patients and underlines the crucial role of a tailored, overarching hemodynamic and respiratory framework in managing this complex clinical condition. Sciendo 2023-07-31 /pmc/articles/PMC10425930/ /pubmed/37588184 http://dx.doi.org/10.2478/jccm-2023-0023 Text en © 2023 Cosmin Balan et al., published by Sciendo https://creativecommons.org/licenses/by/4.0/This work is licensed under the Creative Commons Attribution 4.0 International License. |
spellingShingle | Review Balan, Cosmin Ciuhodaru, Tudor Bubenek-Turconi, Serban-Ion Kidney Injury in Critically Ill Patients with COVID-19 – From Pathophysiological Mechanisms to a Personalized Therapeutic Model |
title | Kidney Injury in Critically Ill Patients with COVID-19 – From Pathophysiological Mechanisms to a Personalized Therapeutic Model |
title_full | Kidney Injury in Critically Ill Patients with COVID-19 – From Pathophysiological Mechanisms to a Personalized Therapeutic Model |
title_fullStr | Kidney Injury in Critically Ill Patients with COVID-19 – From Pathophysiological Mechanisms to a Personalized Therapeutic Model |
title_full_unstemmed | Kidney Injury in Critically Ill Patients with COVID-19 – From Pathophysiological Mechanisms to a Personalized Therapeutic Model |
title_short | Kidney Injury in Critically Ill Patients with COVID-19 – From Pathophysiological Mechanisms to a Personalized Therapeutic Model |
title_sort | kidney injury in critically ill patients with covid-19 – from pathophysiological mechanisms to a personalized therapeutic model |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425930/ https://www.ncbi.nlm.nih.gov/pubmed/37588184 http://dx.doi.org/10.2478/jccm-2023-0023 |
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