Kidney infarction in patient with covid-19: clinical case
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v82i1.788Keywords:
COVID-19 disease, Renal Infarct, Coagulopathy, Renal artery thrombosis, AngioplastyAbstract
Abstract
Description: A 50-year-old male who was admitted to intensive care with a Coronavirus-19 diagnosis for strict handling requiring oxygen therapy. He presented distention and abdominal pain, for which an abdomen-pelvic tomography was requested, reporting lack of filling in the right renal artery and renal infarcts requiring angioplasty and double antiplatelet therapy. The evolution was favorable, and the patient was discharged. Currently, a renal Doppler reports adequate vascularization. The patient presents proper renal function.
Clinical Significance: The coronavirus disease is a contagious and life-threatening infection caused by the severe acute respiratory syndrome coronavirus 2. It can lead patients to arterial and venous thrombosis. However, acute renal artery occlusion is considered a rare disease.
Clinical Implications: Prompt diagnosis and treatment are important to prevent permanent kidney damage or permanent loss of kidney function.
Conclusion: The underlying etiology of renal infarcts remains largely unknown at present, but it may include direct viral cytopathic effects on endothelial cells. Most patients are managed conservatively. Some cases undergo angioplasty successfully. The patient in this case received earlier treatment with doses of anticoagulant enoxaparin, and his glomerular filtration remained stable, although complementary treatment was required.
References
Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2020;75(23):2950–73. doi: 10.1016/j.jacc.2020.04.031
Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 2020;395(10234):1417–8. doi: 10.1016/S0140-6736(20)30937-5
Leisman DE, Deutschman CS, Legrand M. Facing COVID-19 in the ICU: vascular dysfunction, thrombosis, and dysregulated inflammation. Intensive Care Med. 2020;46(6):1105–8. doi: 10.1007/s00134-020-06059-6
Cuevas Tascón G, Salazar Chiriboga DE, Lorente Ramos R, Díaz Díaz D, Rodríguez Ruiz C, Procaccini FL, et al. Infarto renal en paciente con COVID-19. Nefrología. 2021;41(1):84–7. doi: 10.1016/j.nefro.2020.04.008
Connell NT, Battinelli EM, Connors JM. Coagulopathy of COVID‐19 and antiphospholipid antibodies. J Thromb Haemost. 2020;10.1111/jth.14893. doi: 10.1111/jth.14893
Klok FA, Kruip MJHA, Meer NJM van der, Arbous MS, Gommers D a. MPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thrombosis Research. 2020;191:145–7. doi: 10.1016/j.thromres.2020.04.013
Lodigiani C, Iapichino G, Carenzo L, Cecconi M, Ferrazzi P, Sebastian T, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9–14. doi: 10.1016/j.thromres.2020.04.024
Woehl B, Lawson B, Jambert L, Tousch J, Ghassani A, Hamade A. 4 Cases of Aortic Thrombosis in Patients With COVID-19. JACC: Case Reports. 2020;2(9):1397–401. doi: 10.1016/j.jaccas.2020.06.003
Lushina N, Kuo JS, Shaikh HA. Pulmonary, Cerebral, and Renal Thromboembolic Disease in a Patient with COVID-19. Radiology. 2020;296(3):E181–3. doi: 10.1148/radiol.2020201623
Philipponnet C, Aniort J, Chabrot P, Souweine B, Heng A-E. Renal artery thrombosis induced by COVID-19. Clinical Kidney Journal. 2020;13(4):713. doi: 10.1093/ckj/sfaa141
Griffin DO, Jensen A, Khan M, Chin J, Chin K, Saad J, et al. Pulmonary Embolism and Increased Levels of d-Dimer in Patients with Coronavirus Disease. Emerg Infect Dis. 2020;26(8):1941–3. doi: 10.3201/eid2608.201477
Shi W, Lv J, Lin L. Coagulopathy in COVID-19: Focus on vascular thrombotic events. Journal of Molecular and Cellular Cardiology. 2020;146:32–40. doi: 10.1016/j.yjmcc.2020.07.003
Post A, Deurwaarder ESG den, Bakker SJL, Haas RJ de, Meurs M van, Gansevoort RT, et al. Kidney Infarction in Patients With COVID-19. American Journal of Kidney Diseases. 2020;76(3):431–5. doi: 10.1053/j.ajkd.2020.05.004
Park S, Lee GH, Jin K, Park KM, Kim YW, Park BS. Renal Infarction Caused by Isolated Spontaneous Renal Artery Intramural Hematoma. Am J Case Rep. 2015;16:832–6. doi: 10.12659/AJCR.895285
Hazanov N, Somin M, Attali M, Beilinson N, Thaler M, Mouallem M, et al. Acute Renal Embolism: Forty-Four Cases of Renal Infarction in Patients With Atrial Fibrillation. Medicine. 2004;83(5):292–9. doi: 10.1097/01.md.0000141097.08000.99
Silverberg D, Menes T, Rimon U, Salomon O, Halak M. Acute renal artery occlusion: Presentation, treatment, and outcome. Journal of Vascular Surgery. 2016;64(4):1026–32. doi: 10.1016/j.jvs.2016.04.043
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