PD21-01 PATHOLOGICAL CHANGES IN THE KIDNEYS IN PATIENTS WITH ACUTE RENAL INJURY DUE TO CORONAVIRUS INFECTION

Abstract

You have accessJournal of UrologyCME1 May 2022PD21-01 PATHOLOGICAL CHANGES IN THE KIDNEYS IN PATIENTS WITH ACUTE RENAL INJURY DUE TO CORONAVIRUS INFECTION Valentin Pavlov, Dmitry Vishnyakov, Anushavan Papoyan, Aleksandr Alekseev, and Ildar Kabirov Valentin PavlovValentin Pavlov More articles by this author , Dmitry VishnyakovDmitry Vishnyakov More articles by this author , Anushavan PapoyanAnushavan Papoyan More articles by this author , Aleksandr AlekseevAleksandr Alekseev More articles by this author , and Ildar KabirovIldar Kabirov More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002559.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Acute kidney injury (AKI) in coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus is much more common than previously thought and is associated with severe disease and high mortality. Despite the fact that the respiratory and immune systems are the main targets of the COVID-19 virus, AKI is also observed, identified by the occurrence of proteinuria or hematuria, an increase in serum urea and creatinine levels. The aim of the study is to assess the pathomorphological changes in the kidneys in 100 cases of autopsy of patients with COVID-19 using light microscopy and immunohistochemical diagnostic methods in order to clarify the possible mechanism of AKI. METHODS: The study was carried out using samples obtained from 100 patients, the time interval of the onset of the disease corresponded to the 4th wave of the peak of the incidence in Russia (from June 2021). The age of patients varied from 37 to 94 years 72 (σ=12.5), men - 34, women - 66. Patients with chronic kidney disease, diabetes mellitus and cancer were not included in the analysis. The cause of death in all cases was acute respiratory failure, histologically defined as diffuse alveolar injury. AKI in accordance with the KDIGO criteria was detected in 34 patients. RESULTS: On light microscopy, diffuse massive damage to the proximal tubules with loss of the brush border, degeneration of vacuoles was detected in 46 patients, massive necrosis of the tubules in 11 patients. In 65 patients, an extremely pronounced congestion of paretic dilated vessels with widespread paravasal hemorrhages was revealed. Paravasal lymphoid infiltration of the vascular endothelium was detected in 27 patients. Severe sludge syndrome in small and medium-sized vessels in 46 patients. In almost all cases, hemosiderin granules and hyaline casts were found. The quantitative and qualitative composition of tissue macrophages corresponded to the population data, without visible correlations with the disease. CONCLUSIONS: According to the study, the factors contributing to AKI include systemic hypoxia, abnormal coagulation, increased catabolism due to fever, drug-related rhabdomyolysis or hyperventilation with increased serum degradation products. Thus, our research provides evidence for AKI during the progression of COVID-10. These results contribute to a better understanding of the course and progression of SARS-CoV-2 virus infection. Source of Funding: Federal State Budgetary Educational Institution of Higher Education Bashkir State Medical University © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e361 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Valentin Pavlov More articles by this author Dmitry Vishnyakov More articles by this author Anushavan Papoyan More articles by this author Aleksandr Alekseev More articles by this author Ildar Kabirov More articles by this author Expand All Advertisement PDF DownloadLoading ...