Faculty Opinions recommendation of Acute kidney injury in non-severe pneumonia is associated with an increased immune response and lower survival.

Background The causative virus of coronavirus disease 2019 (COVID-19) may cause severe fatal pneumonia. The clinical presentation includes asymptomatic infection, severe pneumonia, and acute respiratory failure. Data pertaining to acute renal injury due to COVID-19 in patients who have undergone renal transplantation are scarce. We herein report two cases of COVID-19 along with acute kidney injury following kidney transplantation. Case presentation: Two patients with COVID-19 underwent renal transplantation and were subsequently diagnosed with acute kidney injury. The first patient presented with progressive respiratory symptoms and acute renal injury. He was treated with diuretics and suspension of immunosuppressive therapy; however, the patient died. The second patient presented with respiratory tract symptoms, hypoxemia, and progressive deterioration of renal function followed by improvement. Her mycophenolate mofetil was stopped after admission, and tacrolimus was discontinued 10 days later. Moxifloxacin and methylprednisolone were continued in combination with albumin and gamma globulin infusion. A diuretic was administered, and prednisone was gradually reduced along with tacrolimus. The patient exhibited a satisfactory clinical recovery. Conclusion Patients who develop COVID-19 after kidney transplantation are at risk of acute kidney injury, and their prednisone, immunosuppressant, and gamma globulin treatment must be adjusted according to their condition.

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Aggressive fluid accumulation is associated with acute kidney injury and mortality in a cohort of patients with severe pneumonia caused by influenza A H1N1 virus

PLoS ONE ◽

10.1371/journal.pone.0192592 ◽

2018 ◽

Vol 13 (2) ◽

pp. e0192592 ◽

Cited By ~ 2

Author(s):

Gustavo Alejandro Casas-Aparicio ◽

Isabel León-Rodríguez ◽

Rafael de Jesús Hernández-Zenteno ◽

Manuel Castillejos-López ◽

Claudia Alvarado-de la Barrera ◽

...

Keyword(s):

Acute Kidney Injury ◽

Influenza A ◽

H1n1 Virus ◽

Kidney Injury ◽

Severe Pneumonia ◽

Fluid Accumulation ◽

Influenza A H1n1

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The innate immune response in ischemic acute kidney injury

Clinical Immunology ◽

10.1016/j.clim.2008.08.016 ◽

2009 ◽

Vol 130 (1) ◽

pp. 41-50 ◽

Cited By ~ 195

Author(s):

Hye Ryoun Jang ◽

Hamid Rabb

Keyword(s):

Immune Response ◽

Acute Kidney Injury ◽

Innate Immune Response ◽

Kidney Injury ◽

Innate Immune ◽

Ischemic Acute Kidney Injury

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FO017UNILATERAL NEPHRECTOMY SUPPRESSES IMMUNE RESPONSE PATHWAYS IN ACUTE KIDNEY INJURY AND OVERCOMES PROGRESSION TO CHRONIC KIDNEY DISEASE IN MICE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy104.fo017 ◽

2018 ◽

Vol 33 (suppl_1) ◽

pp. i8-i8

Author(s):

Lies Moonen ◽

Bart Cuypers ◽

Pieter Meysman ◽

Kris Laukens ◽

Patrick D'Haese ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Immune Response ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Kidney Injury

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Acute kidney injury in patients with severe COVID-19 in Mexico

PLoS ONE ◽

10.1371/journal.pone.0246595 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246595

Author(s):

Gustavo A. Casas-Aparicio ◽

Isabel León-Rodríguez ◽

Claudia Alvarado-de la Barrera ◽

Mauricio González-Navarro ◽

Amy B. Peralta-Prado ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Stress Test ◽

Systemic Disease ◽

Invasive Mechanical Ventilation ◽

Laboratory Data ◽

Kidney Injury ◽

Severe Pneumonia ◽

Older Age ◽

Vasoactive Drugs

Introduction Some patients with COVID-19 pneumonia present systemic disease involving multiple systems. There is limited information about the clinical characteristics and events leading to acute kidney injury (AKI). We described the factors associated with the development of AKI and explored the relation of AKI and mortality in Mexican population with severe COVID-19. Methods We retrospectively reviewed the medical records of individuals with severe pneumonia caused by SARS-CoV-2 hospitalized at the largest third-level reference institution for COVID-19 care in Mexico between March and April 2020. Demographic information, comorbidities, clinical and laboratory data, dates of invasive mechanical ventilation (IMV) and hospitalization, mechanical-ventilator settings and use of vasoactive drugs were recorded. Results Of 99 patients studied, 58 developed AKI (58.6%). The risk factors for AKI were older age (OR = 1.07, 95% CI = 1.01–1.13, p = 0.024); obesity (OR = 6.58, 95% CI = 1.8–24.05, p = 0.040); and the need for IMV (OR = 6.18, CI = 1.29–29.58, p = 0.023). The risk factors for mortality were obesity (OR = 5.57, 95% CI = 1.48–20.93, p = 0.011); requirement of vasoactive drugs on admission (OR = 5.35, 95% CI = 1.16–24.61, p = 0.031); and AKI (OR = 8.61, 95% CI = 2.24–33.1, p = 0.002). In-hospital mortality was significantly higher in patients with AKI stage 3 (79.3%) and AKI stage 2 (68.7%) compared with those with AKI stage 1 (25%; p = 0.004). Fifty-three patients underwent the furosemide stress test (FST) to predict progression to AKI stage 3. Of those, 12 progressed to AKI stage 3 (22%). The ROC curve for the FST had an AUC of 0.681 (p = 0.009); a sensitivity of 81.6% and a specificity of 54.5%. Conclusions AKI was common in our cohort of patients with severe pneumonia caused by SARS-CoV-2 infection. The risk factors for AKI were older age, obesity and the need for of IMV on admission. The risk factors for mortality were obesity, requirement of vasoactive drugs on admission and AKI. Mortality was more frequent in patients with AKI stages 2–3. The FST had an acceptable predictive capacity to identify patients progressing to AKI stage 3.

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P0054ACQUIRED DIFFERENTIAL EXPRESSION IN ACUTE KIDNEY INJURY OF GENES RESPONSIBLE FOR HEREDITARY NEPHROPATHIES

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0054 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Sol Carriazo ◽

Maria Dolores Sanchez-Nino ◽

Maria Vanessa Perez Gomez ◽

Laura Castañeda-Infante ◽

Teresa Stock da Cunha ◽

...

Keyword(s):

Immune Response ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Glomerular Filtration ◽

Murine Model ◽

Rna Processing ◽

Kidney Injury ◽

Protein Activation ◽

Acute Kidney Disease ◽

Hereditary Nephropathies

Abstract Background and Aims Gene sequencing is becoming an important diagnostic tool in a great number of medical specialties. Despite its interpretation is still a challenge, allows the identification of genes related to hereditary diseases and bild a base for the study of acquired nephropathies. We hypothesize that those genes responsible for hereditary nehpropathies could contribute to the pathogenesis of acquired nephropathies. Method In a murine model of acute kidney disease induced by folic acid, we analyzed the kidney transcriptomic after 24 hours of damage. In this database we evaluated if 625 genes described as responsible for hereditary nephropathies were expressed significantly. Later, we evaluated the correlation between diferentially expressed genes and glomerular filtration, using transcriptomic databases of human nephropathies (Nephroseq), so that, we could identify those relevant in acquired human nephropathies and in experimental settings. A functional enrichment analysis was done using the software Gorilla, and some of the genes were validated in our laboratory using RT-PCR. Results In acute kidney disease, the renal expression of 3906/25051 (15.59%) genes increased and the expression of 3537 (14.11%) decreased significantly (p<0.05). The percentage of genes expressed diferentially was higher when analysing the 625 genes responsible of familiar nephropathies. We identified 615 of those in the murine model and 105/615 (17.07%) increased it expression, and 155 (25.20%), decreased it (p<0.05 when compared with the database with 25051 genes). 241 of those 260 diferentially expressed genes (92.69%) where associated significantly with glomerular filtration rate in human nephropathies. The most enriched GO process were “complement activation", "protein activation cascade", "activation of immune response" and "RNA processing”. We have validated the expression of 7 of the genes in acute kidney injury (SLC34A1, SLC34A3, Klotho, MAGED2, NLRP3, FN1, COL4A1), which supports the relevance of the transcriptomic results. Conclusion Genes involved in familiar nephropathies are overexpressed between genes diferentially expressed in acquired nephropathies, suggesting that they could play a role in the pathogenesis of the last, throught the regulation of the RNA processing, protein activation or immune response and complement regulation. The analysis of the functioning of genes responsible for familiar nephropathies in acquired nephropaties could identify new therapeutic targets in kidney damage.

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Respiratory and nonrespiratory COVID-19 complications in patients with obesity: recent developments

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2021-0237 ◽

2022 ◽

Author(s):

Esther Liu ◽

Hudson Lee ◽

Briana Lui ◽

Robert S White ◽

Jon D Samuels

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Risk Factor ◽

Cardiac Injury ◽

Kidney Injury ◽

Severe Pneumonia ◽

Increased Risk ◽

Recent Developments ◽

Pubmed Search ◽

Future Work

This narrative review summarizes recent reports to provide an updated understanding of the multiorgan effects of SARS-CoV-2 infection in obese individuals. A PubMed search of 528 primary articles was performed, with inclusion based on novelty, relevance and redundancy. Obesity confers an increased risk for hospitalization, intensive care unit admission, severe pneumonia, intubation and acute kidney injury in COVID-19 patients. Obesity is also associated with higher levels of inflammatory and thrombotic markers. However, the associations between obesity and mortality or cardiac injury in COVID-19 patients remain unclear. Obesity is a risk factor for several respiratory and nonrespiratory COVID-19 complications. Future work is needed to further explore these relationships and optimize the management of obese COVID-19 patients.

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