Managing kidney disease in COVID-19 positive cases becoming a challenge
On April 23, a 70-year-old man died of COVID-19 at theRajiv Gandhi Government General Hospital here after he testedpositive. Hospital authorities said he had diabetes,hypertension and chronic kidney disease and was on dialysis.
Recently, an elderly woman who was admitted for kidneyproblems at the same hospital tested positive for coronavirusafter she was suspected to have contracted the virus from adoctor who was treating her.
The doctor, in turn, is suspected to have got theinfection from a patient he was treating.
"Effect on the kidney is secondary to hypoxia orcytokines released by the COVID-19. It is generally perceivedthat COVID-19 types of viruses are borne from respiratorysystems lungs - but a growing body of evidence shows thatthe virus also attacks the kidneys either directly or mediatedby excessive immune response seen in severe COVID-19 patientsand not just the lungs," said Dr Suresh Rao, Intensivist withthe city-based MGM Health Care.
Citing the reports of SARS and MERS-CoV infections, hesays Acute Kidney Injury (AKI) had developed in 5 to 15 percent cases, but about 60 to 90 per cent of those casesreported mortality.
"The preliminary reports of COVID-19 patientssuggested a lower incidence (3 to 9 per cent) of AKI, butlater reports indicated a higher frequency of abnormalities. Astudy of 59 patients with COVID-19 revealed that about two-thirds of patients developed a massive leak of protein inurine during their stay in hospital," he said.
A senior state Health official said "chronic kidneydisease stage-5 patients on dialysis are also vulnerable groupbecause of their existing co-morbidities, repeated unavoidableexposure to hospital environment and immunosuppressed state."
"Due to their health conditions, they also developsevere diseases as compared to general population," theofficial said.
Prior to reporting coronavirus cases in Tamil Nadu,the state health department identified the vulnerable groupsincluding those who require dialysis and ensured theirtreatment was not affected. CORR SA