Coronavirus: Kidney Damage Caused by COVID-19
COVID-19 — the disease caused by the coronavirus that’s led to the global pandemic —is known to damage the lungs. But, as more people become infected, more understanding of the disease emerges.
Doctors and researchers are finding that this coronavirus — officially called SARS-CoV-2—can also cause severe and lasting harm to other organs, including the heart and kidneys.
COVID-19 Kidney Damage: A Possible Complication
Some people suffering from severe cases of COVID-19 are showing signs of kidney damage, even those who had no underlying kidney problems before they were infected with the coronavirus. Early reports say that up to 30% of patients hospitalized with COVID-19 in China and New York developed moderate or severe kidney injury. Reports from doctors in New York are saying the percentage could be higher.
Signs of kidney problems in patients with COVID-19 include high protein levels in the urine and abnormal blood work showing elevated creatinine levels. The kidney damage is, in some cases, severe enough to require dialysis.
“Many patients with severe COVID-19 are those with co-existing, chronic conditions, including high blood pressure and diabetes. Both of these increase the risk of kidney disease. Dr. Hussain and Colleagues also see kidney damage in people who did not have kidney problems before they got infected with the virus.
How does COVID-19 damage the kidneys?
The impact of COVID-19 on the kidneys isn’t yet clear. Here are some possibilities doctors and researchers are exploring:
Coronavirus might target kidney cells;
The virus itself infects the kidney cells. Kidney cells have receptors that enable the new coronavirus to attach to them, invade, and make copies of itself, potentially damaging those tissues. Similar receptors are found on cells of the lungs and heart, where the new coronavirus has been shown to cause injury. Another possibility is that kidney problems in patients with the coronavirus are due to abnormally low levels of oxygen in the blood, a result of pneumonia commonly seen in severe cases of the disease.
The body’s reaction to the infection may be responsible as well. The immune response to the new coronavirus can be extreme in some people, leading to a cytokine storm. When that happens, the immune system sends a rush of cytokines into the body. Cytokines are small proteins that help the cells communicate as the immune system fights an infection. However, this sudden, large influx of cytokines can cause severe inflammation. In trying to kill the invading virus, this inflammatory reaction can destroy healthy tissue, including the kidneys.
COVID-19 causes blood clots that might clog the kidneys
The kidneys are like filters that screen out toxins, extra water, and waste products from the body. COVID-19 can cause tiny clots to form in the bloodstream, clogging the smallest blood vessels in the kidney and impairing its function.
Coronavirus Kidney Damage: A Serious Sign
Organ systems like the heart, lungs, liver, and kidneys rely on and support one another’s functions, so when the new coronavirus causes damage in one area, others might be at risk. The kidneys’ essential functions impact the heart, lungs, and other systems. That may be why doctors note that kidney damage arising in patients with COVID-19 is a possible warning sign of a serious, even fatal course of the disease.
Can kidneys recover after COVID-19?
It’s uncertain how many people with COVID-19-related kidney damage regain their kidney function. Patients with acute kidney injury due to COVID-19 who do not require dialysis will have better outcomes than those who need dialysis, and we have seen patients who recover kidney function.
Should I keep taking my high blood pressure medication?
Hypertension (high blood pressure) is a common cause of kidney problems. Hypertension damages the blood vessels of the kidneys and affects their ability to filter the blood. Kidneys also help regulate blood pressure so that kidney damage can worsen hypertension. Over time, hypertension can cause kidney failure. If you are living with hypertension, you might take medication for the problem. You may be reading news reports questioning the safety of taking certain prescription medicines to manage their condition: ACE inhibitors and angiotensin receptor blockers (ARBs).
All professional societies have published articles recommending that you do not change your medications. Staying the course with your prescriptions can lower the risk of heart and kidney damage from unchecked high blood pressure. Patients with kidney issues should stay away from non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. These can raise blood pressure, may directly damage the kidneys, and increase fluid volume in the body, which puts strain on the kidneys.
