Post Covid Syndrome: Kidney Damage as a result of COVID-19
Coronavirus: Kidney Damage Caused Due to COVID-19
COVID-19 the disease caused by the coronavirus that has led to the global pandemic is known to damage the lungs. But, as more people become diseased, more understanding of the disease emerges.
Primary care physicians and researchers are finding that this coronavirus officially known as SARS-CoV-2 could also cause serious and lasting harm in other organs, including the heart and kidneys. C. John Sperati, M.D., M.H.S., an expert in kidney health, expresses how the new coronavirus may affect kidney function as the disease develops and afterward as a person recovers.
COVID-19 Kidney Damage: A Possible Complication
Some people suffering from serious cases of COVID-19 are displaying signs of kidney damage, even those who had no hidden kidney problems before they were diseased with the coronavirus. Early reports say that up to 30 percent of patients hospitalized with COVID-19 in China and New York developed moderate or serious kidney injury. Reports from primary care physicians in New York are saying the percentage could be higher.
Signs of kidney damage problems in patients with COVID-19 include high levels of protein in the urine and unusual blood work.
The kidney damage is, in some cases, serious enough to need dialysis. Some hospitals experiencing surges of patients who are very ill with COVID-19 have reported they are running short on the machines and sterile fluids required to perform these kidney procedures.
“Many patients with serious COVID-19 are those with co-existing, chronic conditions, including high blood pressure and diabetes. Both of these raise the risk of kidney disease,” Sperati says.
But Sperati and other primary care physicians are also seeing kidney damage in people who did not have kidney problems before they got diseased with the virus.
How does COVID-19 damage the kidneys?
The impact of COVID-19 on the kidneys is not yet clear. Here are some possibilities primary care physicians and researchers are exploring:
Coronavirus may target kidney cells
The coronavirus itself infects the cells of the kidney. Kidney cells have receptors that allow the new coronavirus to attach to them, invade, and make copies of itself, possibly damaging those tissues. Same receptors are found on cells of the lungs and heart, where the new coronavirus has been shown to cause injury.
Too little oxygen could cause kidneys to malfunction
Another possibility is that kidney problems in patients with the coronavirus are because of unusually low levels of oxygen in the blood, a result of pneumonia frequently seen in serious cases of the disease.
Cytokine storms could destroy kidney tissue
The body’s reaction to the infection might be responsible as well. The immune response to the new coronavirus could be extreme in some people, leading to what is known as a cytokine storm.
When that occurs, the immune system sends a rush of cytokines into the body. Cytokines are small proteins that help the cells interact as the immune system fights an infection. But this unexpected, large influx of cytokines could cause serious swelling. In trying to kill the attacking virus, this inflammatory reaction could destroy healthy tissue, including that of the kidneys.
COVID-19 causes blood clots that might clog or block the kidneys
The kidneys are like filters or screens that screen out toxins, extra water, and waste products from the body. COVID-19 could cause small clots to form in the bloodstream, which could block the tiniest blood vessels in the kidney and damage its function.
Coronavirus Kidney Damage: A Serious Sign
Organ systems like the heart, lungs, liver, and kidneys depend on and support one another's functions, so when the new coronavirus causes damage in one region, others may be at risk. The kidneys’ important functions have an impact on the heart, lungs, and other systems. That might be why primary care physicians note that kidney damage arising in patients with COVID-19 is a possible warning sign of a severe, even fatal course of the disease.
Can kidneys heal after COVID-19?
As of yet, Sperati says, it is doubtful how many people with COVID-19 associated kidney damage regain their kidney function.
Patients with acute kidney injury because of COVID-19 who do not need dialysis will have better outcomes than those who require dialysis, and we have seen patients at Johns Hopkins who recover kidney function. We have even had patients in the intensive care unit (ICU) with acute kidney injury who have needed dialysis and subsequently regained their kidney function. How frequently that happens is still unknown, but without question, the requirement for dialysis is a worrisome development in patients with COVID-19.
Do I need to continue taking my high blood pressure medication?
Hypertension (high blood pressure) is a frequent cause of kidney problems. Hypertension affects the blood vessels of the kidneys and damages their ability to filter the blood. Kidneys also help to regulate blood pressure, so kidney damage could make hypertension worse. Over time, hypertension could cause kidney failure.
If you are living with hypertension, you may take medication for the problem. You might be reading news reports questioning the safety of taking specific prescription medicines to manage their condition: ACE inhibitors and angiotensin receptor blockers (ARBs).
Sperati says that patients should stay on their medications and discuss concerns with their primary care physicians.
Right now there are two sides debating this problem. One side is saying, based on animal studies, that these medications may be harmful, raising the risk of infection. The other says these same drugs may protect against lung damage and other problems related to COVID-19.
But all of the professional societies have published articles suggesting that you not change your medications, he says. Staying the course with your prescriptions, he adds, could lower the risk of heart and kidney damage from unchecked high blood pressure.
Sperati does suggest that patients with kidney problems stay away from non-steroidal anti-inflammatory drugs (NSAIDs), for example, ibuprofen and naproxen. These could increase blood pressure and increase fluid volume in the body, which puts strain on the kidneys.
Research is disclosing more about SARS-CoV-2 kidney damage
While kidney damage from COVID-19 is still not well understood, more data will disclose how this happens. Sperati, who also conducts research on kidney disease, says the Johns Hopkins Division of Nephrology is exploring exactly how SARS-CoV-2 and the body’s response to it are damaging kidney health.
Patients with COVID-19 associated kidney damage should follow up with their primary care physicians to make sure kidney function is returning to normal. Lasting kidney damage may need dialysis or other therapies even after recovery from COVID-19.
Mostly, Sperati emphasizes the importance of adhering to guidelines around physical distancing and hand-washing, the basics of prevention. For everyone, particularly people with hidden chronic disease, avoiding infection with COVID-19 for as long as you could is important, he says.
Right now, we do not have a treatment or vaccine for this disease. The longer a person could go without getting infected, the better chance they have of benefiting from a future therapy.
If you or anyone you know is suffering from post-covid kidney damage problems, our expert providers at Post Covid Centers will take care of your health and help you recover.