Table 2.
Summary of the mechanism of kidney injury in coronavirus disease 2019
Mechanism of kidney injury
|
Hypovolaemia
|
ARDS related AKI
|
Cytokine storm syndrome associated AKI
|
Direct viral invasion
|
Pre-renal | Fever causing insensible losses; Gastrointestinal volume losses | Haemodynamic instability; High positive end expiratory pressure /intrathoracic pressure; Right heart failure | Haemodynamic instability | |
Renal1 | Inflammation; Hypoxia/hypercapnia; Acid-base dysregulation; Tubular injury | Inflammation; Possible glomerulopathy and TMA ( hypercoagulability) | Inflammation; Possible Tubulopathy; Podocytopathy; Interstitial inflammation | |
Post renal |
The most common intrinsic renal lesion observed is acute tubular necrosis. AKI: Acute kidney injury; ARDS: Acute respiratory distress syndrome; TMA: Thrombotic microangiopathy.