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Am J Kidney Dis Kidney Infarction in Patients With COVID-19

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  • Am J Kidney Dis Kidney Infarction in Patients With COVID-19

    Am J Kidney Dis

    . 2020 May 29;S0272-6386(20)30723-X.
    doi: 10.1053/j.ajkd.2020.05.004. Online ahead of print.
    Kidney Infarction in Patients With COVID-19

    Adrian Post 1 , Edwin S G den Deurwaarder 2 , Stephan J L Bakker 3 , Robbert J de Haas 4 , Matijs van Meurs 5 , Ron T Gansevoort 3 , Stefan P Berger 3



    Coronavirus disease 2019 (COVID-19) is a contagious, life-threatening infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent findings indicate an increased risk of acute kidney injury during COVID-19. The pathophysiological mechanisms leading to acute kidney injury in COVID-19 are unclear, but may include direct cytopathic effects of the virus on kidney tubular and endothelial cells, indirect damage caused by virus-induced cytokine release, and kidney hypoperfusion due to a restrictive fluid strategy. In this case-report we propose an additional pathophysiological mechanism. We describe two cases in which patients with COVID-19 developed a decrease in kidney function due to kidney infarction. These patients did not have atrial fibrillation. One of these patients was treated with therapeutic doses of low molecular weight heparin, whereafter no further deterioration of kidney function was observed. Our findings implicate that the differential diagnosis of acute kidney injury in COVID-19 patients should include kidney infarction, which may have important preventive and therapeutic implications.

    Keywords: Acute kidney injury; COVID-19; Kidney infarction; SARS-CoV-2; anticoagulation.