The coronavirus infection, which can cause many patients to develop kidney failure, can be quite severe, especially in kidney transplant patients. Here are the effects of the coronavirus on the kidneys.
The coronavirus infection caused by the SARS-CoV-2 virus can directly affect the kidneys, and the infection, however, may be more severe in patients with kidney disease.
The kidney is one of the main target organs of the coronavirus and data from different scientific studies confirm this. Many of those hospitalized for coronavirus have impaired kidney function.
While the coronavirus progresses asymptomatically in some people, it can cause many health problems in some people, from respiratory problems to multiple organ dysfunction. The symptoms are very diverse (fever, cough, sore throat, headache, fatigue, shortness of breath, conjunctivitis) and in some patients the disease can progress to pneumonia, respiratory failure and death. This progression is associated with an inflammatory condition known as a cytokine storm.
The coronavirus infects the lungs and can cause pneumonia, but it can also affect multiple organs and systems, such as the heart, digestive system, nervous system, and kidneys.
CORONAVIRUS AFFECTS THE KIDNEYS
One of the knowledge gained since the beginning of the coronavirus epidemic is that the coronavirus has the ability to damage the kidneys of anyone, not just the kidneys of people who have been diagnosed with kidney disease. This is possible because kidney cells (particularly called tubular) produce high amounts of a particular protein (ACE2) that creates a receptor that the virus binds to to enter cells and infect them.
This condition causes many patients to develop kidney failure. In studies, patients with secondary acute renal failure who contracted the coronavirus clearly showed worse prognosis.
Some of these people even need dialysis. Also, in some cases, acute renal failure leads to chronic renal failure. This deterioration may or may not be progressive, but the patient develops chronic kidney damage. However, the kidney always has a certain healing capacity, so permanent kidney damage is not common.
EFFECTS OF CORONAVIRUS ON RENAL PATIENTS
Considering that the coronavirus affects the kidneys of healthy individuals, the effect is even greater in the very large group of kidney patients. It is estimated that about 15 percent of the world’s population may have chronic kidney disease (CKD). Many patients with CKD experience an acute deterioration in kidney function with the coronavirus due to this underlying disease.
The reason for this deterioration is the suppressed immunity of those who need dialysis and, above all, CKD patients, for whom kidney transplantation is prominent. When they catch the coronavirus, the course of the disease can be quite severe. Unfortunately, the risk of death of a transplant or dialysis patient infected with coronavirus increases. Kidney patients are in the group with the highest risk of dying from coronavirus.
The immunosuppressive drugs that kidney transplant patients take to prevent their bodies from rejecting the organ are drugs that keep their defenses in check against infections such as those produced by the coronavirus. However, CKD patients requiring dialysis also have impaired defenses against viruses, bacteria, and other threats. Dialysis patients have a certain degree of immunodeficiency, can be considered partially immunocompromised, and therefore have a worse course of illness when infected with coronavirus.
AN ESSENTIAL WEAPON: VACCINE
A vaccine for the prevention of coronavirus is particularly recommended in the frailest patients, for example with kidney disease. Because of their altered immune status, kidney patients tend to develop fewer antibodies to the coronavirus.
Experts around the world consider that there is sufficient evidence that people undergoing kidney replacement therapy need a third dose of the vaccine. Various experts believe that, as with other vaccines, such as the vaccine to prevent infection by the hepatitis B virus, a higher dose, and sometimes an additional dose, should be administered immunologically in people with advanced chronic kidney disease.
KIDNEY PROBLEMS CAN CONTINUE FOR MONTHS
A very large study shows that kidney problems can persist for months after patients recover from the coronavirus infection, and in some patients the damage can lead to a significant reduction in kidney function.
The study, published Sept. 1 in the Journal of the American Society of Nephrology, found that patients had a higher risk of exposure to kidney damage for a longer period of time at baseline.
Even people who have the virus and have a less severe infection may be vulnerable to kidney damage. One of the study authors, F. Perry Wilson, a Yale University nephrologist and professor of medicine, “Overall, we see an increased risk of a number of major kidney-related events. And what surprises me most is that they persist.” said.
The kidneys play a key role in removing toxins and excess fluid from the blood in the body, maintaining healthy blood pressure, and regulating the balance of electrolytes and other important substances. When the kidneys are not working well or efficiently, fluids build up and cause inflammation, high blood pressure, weak bones and many other problems.
The heart, lungs, central nervous system, and immune system may be impaired. In advanced cases, dialysis or kidney transplant may be required. Kidney problems can also cause death.
This new study, based on patient records from the health system, analyzed the information of 89 thousand 216 people who tested positive for coronavirus between March 1, 2020 and March 15, 2021, as well as the information of 1 million 637 thousand 467 people without coronavirus.
Ziyad Al-Aly, director of the research and development service, said that 1 to 6 months after being infected, coronavirus survivors are roughly 35 percent more likely to experience kidney damage or significant deterioration in kidney function than those without the coronavirus.
Stating that many people with reduced kidney function do not experience pain or other symptoms, experts underline that people should know that coronavirus is a risk for the kidneys and be very careful about kidney damage.