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. 2022 Mar 14;15(9):1698-1704.
doi: 10.1093/ckj/sfac079. eCollection 2022 Sep.

COVID-19 infection and renal injury: where is the place for acute interstitial nephritis disease?

Juan León-Román  1 , Irene Agraz  1 , Ander Vergara  1 , Natalia Ramos  1 , Nestor Toapanta  1 , Clara García-Carro  2 , Alejandra Gabaldón  3 , Roxana Bury  1 , Sheila Bermejo  1 , Oriol Bestard  1 , María José Soler  1
Affiliations

COVID-19 infection and renal injury: where is the place for acute interstitial nephritis disease?

Juan León-Román et al. Clin Kidney J. .

Abstract

Novel coronavirus disease infection (coronavirus disease 2019, COVID-19) was declared a global pandemic in March 2020 and since then has become a major public health problem. The prevalence of COVID-19 infection and acute kidney injury (AKI) is variable depending on several factors such as race/ethnicity and severity of illness. The pathophysiology of renal involvement in COVID-19 infection is not entirely clear, but it could be in part explained by the viral tropism in the kidney parenchyma. AKI in COVID-19 infection can be either by direct invasion of the virus or as a consequence of immunologic response. Diverse studies have focused on the effect of COVID-19 on glomerulonephritis (GN) patients or the 'novo' GN; however, the effect of COVID-19 in acute tubulointerstitial nephritis (ATIN) has been scarcely studied. In this article, we present five cases with different spectrums of COVID-19 infection and ATIN that may suggest that recent diagnosis of ATIN is accompanied by a worse clinical prognosis in comparison with long-term diagnosed ATIN.

Keywords: COVID-19; SARS-CoV-2; acute kidney injury; acute tubulointerstitial nephritis; kidney biopsy.

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Figures

None
Graphical abstract
Figure 1:
Figure 1:
Spectrum of kidney damage in COVID-19 infection. The kidney damage lesions in the different compartments namely glomeruli, tubuli and renal vasculature associated with COVID-19 infection are shown in this picture. Interestingly, COVID-19 infection in the kidney has been associated with several diseases such as focal and segmental glomerulosclerosis, acute interstitial injury and thrombotic microangiopathy.
Figure 2:
Figure 2:
Histopathology of the kidney biopsy performed in the second case. Acute tubulointerstitial nephritis and acute tubular damage are shown in haematoxylin eosin staining. (A) White arrow shows interstitial inflammatory infiltrates in low power light micrograph. (B) White and black arrows show tubulitis and eosinophils, respectively. SARS-CoV-2 immunohistochemistry was negative.
See this image and copyright information in PMC

Comment in

  • doi: 10.1093/ndt/sfac147

References

    1. Farouk S, Fiaccadori E, Cravedi Pet al. . COVID-19 and the kidney: what we think we know so far and what we don't. J Nephrol 2020; 33: 1213–1218 - PMC - PubMed
    1. Ng JH, Hirsch JS, Hazzan Aet al. . Outcomes among patients hospitalized with COVID-19 and acute kidney injury. Am J Kidney Dis 2021; 77: 204–215.e1 - PMC - PubMed
    1. Hirsch J, Mersema A, Ross D, et al. . Acute kidney injury in patients hospitalized with COVID-19. Kidney Int 2020; 98: 209–218 - PMC - PubMed
    1. Batlle D, Soler MJ, Sparks MAet al. . COVID-19 and ACE2 in cardiovascular, lung, and kidney working group. Acute kidney injury in COVID-19: emerging evidence of a distinct pathophysiology. J Am Soc Nephrol 2020; 31: 1380–1383 - PMC - PubMed
    1. Golmai P, Larsen CP, DeVita MVet al. . Histopathologic and ultrastructural findings in postmortem kidney biopsy material in 12 patients with AKI and COVID-19. J Am Soc Nephrol 2020; 31: 1944–1947 - PMC - PubMed