2.2 COVID-19 infection and chronic kidney
disease
Patients with chronic kidney disease (CKD) are predisposed to COVID-19
(Yang et al., 2020). Emerging reports suggest that patients with
pre-existing kidney injuries got worse after testing positive and being
admitted to the hospital for COVID-19. In one study, there was an
elevation in markers of renal function, elevation of serum D-dimer,
pro-inflammatory cytokines particularly interleukin-6 as well as
neutrophilia (Yang et al., 2020). It is currently unclear as to the
extent the virus directly damages renal tubular epithelial cells or
whether the kidney injury is secondary to the cytokine storm syndrome
(Cheng et al., 2020; Qian et al., 2020). In a study involving 1,603
patients with COVID-19, 21% presented with increased serum creatinine
levels while 43.5% of them had a previously diagnosed CKD stage 3 or
higher and with higher mortality rates than in the non-CKD group
(Portoles et al., 2020). In these CKD patients (n = 146), urea, serum
potassium, urinary proteins, D-dimer, procalcitonin, lactate and
troponins levels were elevated while hemoglobin, platelets, albumin and
estimated glomerular filtration rate were decreased. Mortality was high
in COVID-19 patients with elevated serum creatinine (32.4%) and those
with previously diagnosed CKD (41.1%) than those with normal serum
creatinine levels (5.8%) (Portoles et al., 2020). In summary, COVID-19
infection appears to damage the kidney and may accelerate the death of
patients with CKD.