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For further information, see CMDT Part 22-10: COVID-19 & The Kidney

Key Features

  • Broad array of clinical presentation and kidney pathology

  • Nearly half of patients hospitalized with COVID-19 present with or develop acute kidney injury (AKI), which is associated with poorer prognosis

  • Many causes of AKI are described in patients with COVID-19, but the most common is acute tubular necrosis related to a high inflammatory state (termed "cytokine storm")

  • Another emerging entity described is COVID-19–associated collapsing glomerulopathy, which is a type of focal segmental glomerulosclerosis

Clinical Findings

  • Patients with collapsing glomerulopathy present with nephrotic syndrome and are typically of African ancestry, highlighting a suspected genetic predisposition

Diagnosis

  • Urinalysis may additionally reveal hematuria, reflecting endothelial injury and fibrin thrombi that are commonly observed on biopsy

Treatment

  • COVID-19–related AKI: Largely supportive

  • COVID-19–associated collapsing glomerulopathy: The role of corticosteroids is under investigation

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