diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12506diaendo-12506Research ArticleОбзорыReviewCOVID-19 и почкиCOVID-19 and kidneyshttps://orcid.org/0000-0002-3433-0142ШамхаловаМинара ШамхаловнаShamkhalovaM. S.

д.м.н.

MD, PhD

shamkhalova@mail.ruhttps://orcid.org/0000-0002-9717-9742МокрышеваНаталья ГеоргиевнаMokryshevaN. G.

д.м.н., профессор, член-корр. РАН

MD, PhD, Professor

nm70@mail.ruhttps://orcid.org/0000-0002-5057-127XШестаковаМарина ВладимировнаShestakovaM. V.

д.м.н., профессор, академик РАН

MD, PhD, Professor

nephro@endocrincentr.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation202010082020233235241Copyright © Шамхалова М.Ш., Мокрышева Н.Г., Шестакова М.В., 20202020Шамхалова М.Ш., Мокрышева Н.Г., Шестакова М.В.Shamkhalova M.S., Mokrysheva N.G., Shestakova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12506

COVID-19 представляет собой реальную угрозу для пациентов с сопутствующими заболеваниями, такими как сахарный диабет (СД), гипертония, сердечно-сосудистые, почечные или печеночные нарушения. Поражение почек у лиц с СД, подвергшихся новой инфекции, представляется весьма вероятным, а риск развития острого почечного повреждения – ассоциированным со смертностью. Потенциальные механизмы вовлечения почек в клиническую картину заболевания могут включать цитокиновые повреждения, перекрестные органные повреждения и системные эффекты, определяющие лечебную стратегию. Эти механизмы тесно взаимосвязаны и имеют особенно важное значение для лиц на экстракорпоральной терапии и с трансплантированной почкой. Данные аутопсий предоставляют доказательства инвазии вируса SARS-CoV-2 в ткани почек с повреждением клеток канальцевого эпителия и подоцитов, агрегацией эритроцитов у лиц с тяжелой формой COVID-19. Включая лиц с хронической болезнью почек в планируемые протоколы исследований по COVID-19, можно получить доказательную базу эффективных и безопасных методов лечения.

COVID-19 poses a real threat to patients with comorbid conditions such as diabetes mellitus (DM), hypertension, cardiovascular, renal or hepatic disorders. Kidney damage is very likely in people with diabetes who have undergone a new infection, and the risk of developing acute renal injury is associated with mortality. Potential mechanisms of kidney involvement in the clinical picture of the disease may include cytokine damage, cross-organ damage, and systemic effects that determine the treatment strategy. These mechanisms are closely interrelated and are important for individuals on extracorporeal therapy and kidney transplants. Autopsy data provide evidence of SARS-CoV-2 virus invasion into kidney tissue with damage to tubular epithelium cells and podocytes, and red blood cell aggregation in severely COVID-19 patients. By including individuals with chronic kidney disease in planned COVID-19 research protocols, an evidence base for effective and safe treatments can be generated.

COVID-19сахарный диабетострое почечное повреждениедиализпочечный трансплантатCOVID-19diabetes mellitusacute kidney injurydialysiskidney transplantReferencesLeung C. Clinical features of deaths in the novel Coronavirus epidemic in China. Rev Med Virol. 2020;30(3):e2103. doi: https://doi.org/10.1002/rmv.2103Leung C. Clinical features of deaths in the novel Coronavirus epidemic in China. Rev Med Virol. 2020;30(3):e2103. doi: https://doi.org/10.1002/rmv.2103Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020;97(5):829−838. doi: https://doi.org/10.1016/j.kint.2020.03.005Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020;97(5):829−838. doi: https://doi.org/10.1016/j.kint.2020.03.005Tang N, Bai H, Chen X, et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094−1099. doi: https://doi.org/10.1111/jth.14817Tang N, Bai H, Chen X, et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094−1099. doi: https://doi.org/10.1111/jth.14817Schoen K, Horvat N, Guerreiro NF, et al. Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity. BMC Infect Dis. 2019;19(1):964. doi: https://doi.org/10.1186/s12879-019-4592-0Schoen K, Horvat N, Guerreiro NF, et al. Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity. BMC Infect Dis. 2019;19(1):964. doi: https://doi.org/10.1186/s12879-019-4592-0Yang JK, Feng Y, Yuan MY, et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabetic Med. 2006;23(6):623−628. doi: https://doi.org/10.1111/j.1464-5491.2006.01861.xYang JK, Feng Y, Yuan MY, et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabetic Med. 2006;23(6):623−628. doi: https://doi.org/10.1111/j.1464-5491.2006.01861.xBanik GR, Alqahtani AS, Booy R, Rashid H. Risk factors for severity and mortality in patients with MERS-CoV: analysis of publicly available data from Saudi Arabia. Virol Sin. 2016;31(1):81–84. doi: https://doi.org/10.1007/s12250-015-3679-zBanik GR, Alqahtani AS, Booy R, Rashid H. Risk factors for severity and mortality in patients with MERS-CoV: analysis of publicly available data from Saudi Arabia. Virol Sin. 2016;31(1):81–84. doi: https://doi.org/10.1007/s12250-015-3679-zKoye DN, Magliano DJ, Nelson RG, Pavkov ME. The global epidemiology of diabetes and kidney disease. Adv Chronic Kidney Dis. 2018;25(2):121−132. doi: https://doi.org/10.1053/j.ackd.2017.10.011Koye DN, Magliano DJ, Nelson RG, Pavkov ME. The global epidemiology of diabetes and kidney disease. Adv Chronic Kidney Dis. 2018;25(2):121−132. doi: https://doi.org/10.1053/j.ackd.2017.10.011Fox CS, Matsushita K, Woodward M, et al. Associations of kidney diseases measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet. 2012;380(98540):1662−1673. doi: https://doi.org/10.1016/S0140-6736(12)61350-6Fox CS, Matsushita K, Woodward M, et al. Associations of kidney diseases measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet. 2012;380(98540):1662−1673. doi: https://doi.org/10.1016/S0140-6736(12)61350-6Larsen CP, Bourne TD, Wilson JD, et al. Collapsing glomerulopathy in a patient with coronavirus disease 2019 (COVID-19). Kidney Int Rep. 2020;5(6):935−939. doi: https://doi.org/10.1016/j.ekir.2020.04.002Larsen CP, Bourne TD, Wilson JD, et al. Collapsing glomerulopathy in a patient with coronavirus disease 2019 (COVID-19). Kidney Int Rep. 2020;5(6):935−939. doi: https://doi.org/10.1016/j.ekir.2020.04.002The team of Zhong Nanshan responded that the isolation of SARS-CoV-2 from urine remind us to pay more attention to the cleaning of individuals and families. Guangzhou Daily [cited 2020 February 22].The team of Zhong Nanshan responded that the isolation of SARS-CoV-2 from urine remind us to pay more attention to the cleaning of individuals and families. Guangzhou Daily [cited 2020 February 22].Chu KH, Tsang WK, Tang CS, et al, Acute renal impairment in coronavirus-associated severe acute respiratory syndrome. Kidney Int. 2005;67(2):698–705. doi: https://doi.org/10.1111/j.1523-1755.2005.67130.xChu KH, Tsang WK, Tang CS, et al, Acute renal impairment in coronavirus-associated severe acute respiratory syndrome. Kidney Int. 2005;67(2):698–705. doi: https://doi.org/10.1111/j.1523-1755.2005.67130.xChen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–513. doi: https://doi.org/10.1016/S0140-6736(20)30211-7Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–513. doi: https://doi.org/10.1016/S0140-6736(20)30211-7Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. https://doi.org/10.1056/NEJMoa2002032Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. https://doi.org/10.1056/NEJMoa2002032Li Z, Wu M, Guo J, et al. Caution on kidney dysfunctions of 2019-nCoV patients. medRxiv. 2020. https://doi.org/10.1101/2020.02.08.20021212Li Z, Wu M, Guo J, et al. Caution on kidney dysfunctions of 2019-nCoV patients. medRxiv. 2020. https://doi.org/10.1101/2020.02.08.20021212Hirsch JS, Ng JH, Ross DW, et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. 2020;98(1):209−218. doi: https://doi.org/10.1016/j.kint2020.05.006Hirsch JS, Ng JH, Ross DW, et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. 2020;98(1):209−218. doi: https://doi.org/10.1016/j.kint2020.05.006Ronco C, Reis T. Kidney involvement in COVID-19 and rationale for extracorporeal therapies. Nat Rev Nephrol. 2020;16(6):308−310. doi: https://doi.org/10.1038/s41581-020-0284-7Ronco C, Reis T. Kidney involvement in COVID-19 and rationale for extracorporeal therapies. Nat Rev Nephrol. 2020;16(6):308−310. doi: https://doi.org/10.1038/s41581-020-0284-7Husain-Syed F, Slutsky AS, Ronco C. Lung-kidney cross-talk in the critically ill patient. Am J Respir Crit Care Med. 2016;194(4):402−414. doi: https://doi.org/10.1164/rccm.201602-0420CPHusain-Syed F, Slutsky AS, Ronco C. Lung-kidney cross-talk in the critically ill patient. Am J Respir Crit Care Med. 2016;194(4):402−414. doi: https://doi.org/10.1164/rccm.201602-0420CPPanitchote A, Mehkri O, Hastings A, et al. Factors associated with acute kidney injury in acute respiratory distress syndrome. Ann Intensive Care. 2019;9(1):74. doi: https://doi.org/10.1186/s13613-019-0552-5Panitchote A, Mehkri O, Hastings A, et al. Factors associated with acute kidney injury in acute respiratory distress syndrome. Ann Intensive Care. 2019;9(1):74. doi: https://doi.org/10.1186/s13613-019-0552-5Wu C. Chen I, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;e200994. https://doi.org/10.1001/jamainternmed.2020.0994Wu C. Chen I, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;e200994. https://doi.org/10.1001/jamainternmed.2020.0994Su H, Yang M. Wan Ch, et al. Renal histopathological analysis of 26 postmortem findigs of patients with COVID-19 in China. Kidney International. 2020;98(1):219-227. doi: https://doi.org/10.1016/j.kint.2020.04.003Su H, Yang M. Wan Ch, et al. Renal histopathological analysis of 26 postmortem findigs of patients with COVID-19 in China. Kidney International. 2020;98(1):219-227. doi: https://doi.org/10.1016/j.kint.2020.04.003Ma Y, Diao B, Lv X, Zhu J. 2019 novel coronavirus disease in hemodialysis (HD) patients: report from one HD center in Wuhan, China. medRxiv. 2020. doi: https://doi.org/10.1101/2020.02.24.20027201Ma Y, Diao B, Lv X, Zhu J. 2019 novel coronavirus disease in hemodialysis (HD) patients: report from one HD center in Wuhan, China. medRxiv. 2020. doi: https://doi.org/10.1101/2020.02.24.20027201Expert Team of Chinese Medical Association Nephrology Branch. Recommendations for prevention and control of novel coronavirus infection in blood purification center (room) from Chinese Medical Association Nephrology Branch. Chin J Nephrol. 2020;36:82–84.Expert Team of Chinese Medical Association Nephrology Branch. Recommendations for prevention and control of novel coronavirus infection in blood purification center (room) from Chinese Medical Association Nephrology Branch. Chin J Nephrol. 2020;36:82–84.Hwang S-J. Guideline for dialysis facilities during COVID-19 outbreak. Taiwan Society of Nephrology [cited 2020 March 16].Hwang S-J. Guideline for dialysis facilities during COVID-19 outbreak. Taiwan Society of Nephrology [cited 2020 March 16].Naicker S, Yang CW, Hwang S, et al. The novel coronavirus 2019 epidemic and kidneys. Kidney International. 2020;97(5):824−828. doi: https://doi.org/10.1016/j.kint.2020.03.001Naicker S, Yang CW, Hwang S, et al. The novel coronavirus 2019 epidemic and kidneys. Kidney International. 2020;97(5):824−828. doi: https://doi.org/10.1016/j.kint.2020.03.001Fishman JA, Grossi PA. Novel coronavirus-19 (COVID-19) in the immunocompromised transplant recipient: #Flatteningthecurve. Am J Transplant. 2020;20(7):1765−1767. doi: https://doi.org/10.1111/ajt.15890Fishman JA, Grossi PA. Novel coronavirus-19 (COVID-19) in the immunocompromised transplant recipient: #Flatteningthecurve. Am J Transplant. 2020;20(7):1765−1767. doi: https://doi.org/10.1111/ajt.15890Akalin E, Azzi Y, Bartash R, et al. Covid-19 and kidney transplantation. N Engl J Med. 2020;382(25):2475−2477. doi: https://doi.org/10.1056/NEJMc2011117Akalin E, Azzi Y, Bartash R, et al. Covid-19 and kidney transplantation. N Engl J Med. 2020;382(25):2475−2477. doi: https://doi.org/10.1056/NEJMc2011117Pereira MR, Mohan S, Cohen DJ, et al. COVID-19 in solid organ transplant recipients: initial report from the US epicenter. Am J Transplant. 2020;20(7):1800−1808. doi: https://doi.org/10.1111/ajt.15941Pereira MR, Mohan S, Cohen DJ, et al. COVID-19 in solid organ transplant recipients: initial report from the US epicenter. Am J Transplant. 2020;20(7):1800−1808. doi: https://doi.org/10.1111/ajt.15941Columbia University Kidney Transplant Program. Early description of coronavirus 2019 disease in kidney transplant recipients in New York. J Am Soc Nephrol. 2020;31(6):1150−1156. doi: https://doi.org/10.1681/ASN.2020030375Columbia University Kidney Transplant Program. Early description of coronavirus 2019 disease in kidney transplant recipients in New York. J Am Soc Nephrol. 2020;31(6):1150−1156. doi: https://doi.org/10.1681/ASN.2020030375Fernandez-Ruiz M, Andres A, Loinaz C, et al. COVID-19 in solid organ transplant recipients: a single-center case series from Spain. Am J Transplant. 2020;20(7):1849−185. doi: https://doi.org/10.1111/ajt.15929Fernandez-Ruiz M, Andres A, Loinaz C, et al. COVID-19 in solid organ transplant recipients: a single-center case series from Spain. Am J Transplant. 2020;20(7):1849−185. doi: https://doi.org/10.1111/ajt.15929Alberici FD, Delbarba E, Manenti C, et al. A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia. Kidney Int. 2020;97(6):1083−1088. doi: https://doi.org/10.1016/j.kint.2020.04.002Alberici FD, Delbarba E, Manenti C, et al. A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia. Kidney Int. 2020;97(6):1083−1088. doi: https://doi.org/10.1016/j.kint.2020.04.002Banerjee DP, Shah S, Ster IC, et al. COVID-19 infection in kidney transplant recipients. Kidney Int. 2020;97(6):1076−1082. doi: https://doi.org/10.1016/j.kint.2020.03.018Banerjee DP, Shah S, Ster IC, et al. COVID-19 infection in kidney transplant recipients. Kidney Int. 2020;97(6):1076−1082. doi: https://doi.org/10.1016/j.kint.2020.03.018Lubetzky M, Aull M, Shapiro-Craig R, et al. Kidney allograft recipients diagnosed with coronavirus disease-2019: a single center report. Nephrol Dial Transplant. 2020. https://doi.org/10.1101/2020.04.30.20086462Lubetzky M, Aull M, Shapiro-Craig R, et al. Kidney allograft recipients diagnosed with coronavirus disease-2019: a single center report. Nephrol Dial Transplant. 2020. https://doi.org/10.1101/2020.04.30.20086462López V, Vázquez T, Alonso-Titos J, et al. Recommendations on management of the SARS-CoV-2 coronavirus pandemic (Covid-19) in kidney transplant patients. Nefrologia. 2020;40(3):265−271. https://doi.org/10.1016/j.nefro.2020.03.002López V, Vázquez T, Alonso-Titos J, et al. Recommendations on management of the SARS-CoV-2 coronavirus pandemic (Covid-19) in kidney transplant patients. Nefrologia. 2020;40(3):265−271. https://doi.org/10.1016/j.nefro.2020.03.002Société Francophone de Transplantation (SFT); Société Francophone de Néphrologie, Dialyse et Transplantation (SFNDT) Groupe Infection et immunodépression; Société de pathologie infectieuse de langue franceaise (SPILF). Prise en charge de l’infection due au SARS-CoV-2 chez les patients adultes transplantés d’organe solide 2020 [cited 2020 May 1]. Available at: https://www.sfndt.org/sites/www.sfndt.org/files/medias/documents/Recos%20COVID19%20guide%20pratique%20SFT%20SFNDT%20SPILF%2003%2004%2020.pdfSociété Francophone de Transplantation (SFT); Société Francophone de Néphrologie, Dialyse et Transplantation (SFNDT) Groupe Infection et immunodépression; Société de pathologie infectieuse de langue franceaise (SPILF). Prise en charge de l’infection due au SARS-CoV-2 chez les patients adultes transplantés d’organe solide 2020 [cited 2020 May 1]. Available at: https://www.sfndt.org/sites/www.sfndt.org/files/medias/documents/Recos%20COVID19%20guide%20pratique%20SFT%20SFNDT%20SPILF%2003%2004%2020.pdfBritish Transplant Society. Guidance on the management of transplant recipients diagnosed with or suspected of having COVID19 [cited 2020 May 1]. Available at: https://bts.org.uk/wp-content/uploads/2020/07/Clinical-management-of-transplants-and-immunosuppression-updated-9th-July.pdfBritish Transplant Society. Guidance on the management of transplant recipients diagnosed with or suspected of having COVID19 [cited 2020 May 1]. Available at: https://bts.org.uk/wp-content/uploads/2020/07/Clinical-management-of-transplants-and-immunosuppression-updated-9th-July.pdfAmerican Society of Transplantation. 2019-nCoV (Coronavirus): FAQs for organ donation and transplantation [cited 2020 May 1]. Available at: https://www.myast.org/sites/default/files/COVID19%20FAQ%20Tx%20Centers%2003.20.2020-FINAL.pdfAmerican Society of Transplantation. 2019-nCoV (Coronavirus): FAQs for organ donation and transplantation [cited 2020 May 1]. Available at: https://www.myast.org/sites/default/files/COVID19%20FAQ%20Tx%20Centers%2003.20.2020-FINAL.pdfMaggiore U, Abramowicz D, Crespo M, et al. How should I manage immunosuppression in a kidney transplant patient with COVID-19? An ERA-EDTA DESCARTES expert opinion. Nephrol Dial Transplant. 2020;35(6):899−904. doi: https://doi.org/10.1093/ndt/gfaa130Maggiore U, Abramowicz D, Crespo M, et al. How should I manage immunosuppression in a kidney transplant patient with COVID-19? An ERA-EDTA DESCARTES expert opinion. Nephrol Dial Transplant. 2020;35(6):899−904. doi: https://doi.org/10.1093/ndt/gfaa130

The authors declare that there are no conflicts of interest present.