MODERN APPROACHES TO KIDNEY REPLACEMENT THERAPY OF COVID-ASSOCIATED NEPHROPATHIES
DOI:
https://doi.org/10.37321/nefrology.2022.30-31-04Keywords:
COVID-19, COVID-associated nephropathy, cytokine storm, renal replacement therapy.Abstract
Introduction. Kidney damage is one of the manifestations of coronavirus disease. Frequency of renal dysfunction in patients with COVID-19 is 15-29%.
Goal. To investigate and summarize information on current approaches to renal replacement therapy of COVID-associated nephropathy.
Materials and methods. Bibliographic – a theoretical analysis is carried out and a generalization of literature data is carried out, the actual content is analyzed.
Results and discussion. Possible mechanisms of COVID-associated nephropathy include dehydration, ischemia, direct cytopathic action of the virus due to exposure to ACE2 receptors, accumulation of proinflammatory circulating immune complexes – the so-called cytokine storm – and toxic effects of medications. Differentiation of renal dysfunction in patients with coronavirus disease into primary and secondary gives an opportunity to provide a theoretical basis for the development of recommendations for the management and prevention of this complication. Correction of renal dysfunction depends on its type: primary or secondary. Elimination and prevention of cytokine storm is an effective way of primary kidney dysfunction management; renal replacement therapy should be used in the case of secondary dysfunction.
Conclusions. Clinicians should consider renal dysfunction as a predictor of the adverse course of the disease. In primary dysfunction, rapid reduction of inflammatory manifestations at the initial stage of the disease and prevention of additional nephron damage are effective. In secondary dysfunction, renal replacement therapy should be used.
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