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COVID-19 AND THE KIDNEYS

COVID-19, Coronavirus Disease 2019, caused by the virus SARS CoV-2 is a respiratory illness that can be transmitted from person to person through respiratory droplets. It was originally identified in Wuhan, China in December 2019 and has rapidly spread throughout the world. Many people who become infected with the disease develop mild or no symptoms, though a significant subset of the population who become infected develop severe illness requiring hospitalization and intensive care. Some recent studies have shown that patients hospitalized with COVID-19 pneumonia have a 25-50 percent risk of developing blood or protein in their urine and/or acute renal failure. This alarming data has increased the sense of urgency to find ways to protect the kidneys in patients and improve survival. It is not yet known whether the acute renal failure seen in COVID-19 is a result of multiorgan failure which is seen often in critically ill patients in general,  or whether the virus has a direct effect against the kidneys. The effect is most likely multifactorial. There is emerging evidence that COVID-19 patients may be prone to developing blood clots. When there is a flood of inflammatory molecules, also known as a "cytokine storm," this causes a cascade of dysfunction in the lining of the blood vessels in the body which can also contribute to clot formation. The angiotensin converting enzyme 2(ACE-2) receptor that allows the virus to infect lung cells also allows the virus to infect kidney cells. The ACE-2 receptor is highly expressed in the tubular epithelial cells of the kidney. The findings of blood and protein in the urine is highly suggestive that there is a direct attack on the kidneys; however, studies are underway to examine this question. There are still many unknowns including the severity of kidney involvement. Those with underlying illnesses and comorbidities such as chronic kidney disease may be at increased risk for complications secondary to COVID-19. If you have concerns about your kidney health and the effects of the COVID-19 on your kidneys, please call 817-233-6923 to schedule an appointment.  



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