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