Abstract: PO0770
Collapsing/Sclerosing Glomerulopathy (CSG) and Acute Tubular Injury (ATI) in Patients with COVID-19
Session Information
- COVID-19: CKD and Transplant Patients
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Trainee Case Report
- 000 Coronavirus (COVID-19)
Authors
- Sherchan, Sunil, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Kahila, Mohamed, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Durrani, Jamrose K., SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Puri, Isha, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Mohamed, Ibrahim A., SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Melaku, Yohannes, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Yap, Ernie, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Leonardo, Robert F., SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Saggi, Subodh J., SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Salifu, Moro O., SUNY Downstate Health Sciences University, Brooklyn, New York, United States
- Nicastri, Anthony D., SUNY Downstate Health Sciences University, Brooklyn, New York, United States
Introduction
AKI in patients with COVID-19 may be due to ATI from hemodynamic instability or inflammatory responses. We present two cases of CSG and ATI in patients admitted for COVID-19
Case Description
Case 1 25-year-old black obese female admitted with fever, cough, dyspnea and serum creatinine of 1.4 mg/dL, discharged next day with home quarantine. Re-admitted 26 days later due to nausea, fatigue, and bilateral foot swelling. Serum creatinine 28 mg/dl and urine protein to creatinine ratio (uPCR) of 10.4 g/g
Case 2 42-year-old black female with hypertension, diabetes mellitus admitted with fever, dyspnea, cough, and diarrhea. Patient found to have diabetic ketoacidosis, serum creatinine 12.7 mg/dl. She developed deep vein thrombosis and pulmonary embolism and uPCR 15.4 g/g. She was started on hemodialysis
Kidney biopsy showed global and segmental capillary collapse with a variable degree of sclerosis and severe renal tubules injury. Electron microscopy showed spherical structures in the podocytes, endothelial cells, and tubular epithelium similar to Coronavirus particles
Discussion
Our experience above is part of a growing literature describing the direct visualization of SARS-CoV-2 in causing ATI and CSG. Pathogenetic pathways remain to be elucidated
Capillary collapse.
Viral particles with preserved foot processes