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Dr. Prakash V Kotecha MD, MSc
Health Specialist
Asian Pacific Community in Action
In this paper, we will discuss effects of COVID-19 on kidneys and will relate that to World Kidney Day and its theme for preparing for the unexpected, supporting the vulnerable. Finally, we will derive recommendations for prevention and protection for the community and for the individuals for effect on kidney due to COVID-19.
Coronavirus Disease and Kidney
Kidney damage is a known complication of COVID-19 disease. Signs of kidney problems in patients with COVID-19 include high levels of protein or blood in the urine and abnormal blood work which are very similar to kidney damage by any other reason.
Studies indicate more than 30% of patients hospitalized with COVID-19 develop kidney injury, and more than 50% of patients in the intensive care unit with kidney injury may require dialysis.
The kidneys’ essential functions have an impact on the heart, lungs, and other systems. That is the reason why doctors note that kidney damage arising in patients with COVID-19 is a possible warning sign of a serious, even fatal course of the disease.
How does COVID-19 effect Kidney? (See fig 1)
- Coronavirus might target kidney cells.
The virus itself infects the cells of the kidney. Kidney cells have receptors that enable the new coronavirus to attach to them, invade, and make copies of itself, potentially damaging those tissues.
- Too little oxygen can cause kidneys to malfunction.
Another possibility is that kidney problems in patients with the coronavirus are due to abnormally low levels of oxygen in the blood, a result of the pneumonia commonly seen in severe cases of the disease.
- Cytokine storms can destroy kidney tissue.
The immune response to the new coronavirus can be extreme in some people, leading to what is called a cytokine storm. When that happens, the immune system sends a rush of cytokines into the body. Cytokines are small proteins that help the cells communicate as the immune system fights an infection. But this sudden, large influx of cytokines can cause severe inflammation. In trying to kill the invading virus, this inflammatory reaction can destroy healthy tissue, including that of the kidneys.
- COVID-19 causes blood clots that might clog the kidneys.
The kidneys are like filters that screen out toxins, extra water, and waste products from the body. COVID-19 can cause tiny clots to form in the bloodstream, which can clog the smallest blood vessels in the kidney and impair its function.
Can Kidney Recover after Coronavirus Disease?
Patients with acute kidney injury due to COVID-19 who do not require dialysis will have better outcomes than those who need dialysis. Patients with acute kidney injury requiring dialysis are much more likely to die than patients without acute kidney injury. In those who survive, approximately a third will not regain complete kidney function by the time of discharge from the hospital.
Patients on antihypertensive medicine should continue to take antihypertensive medicine since high blood pressure can further damage kidney otherwise. Patients with kidney issues should stay away from non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. These can raise blood pressure and increase fluid volume in the body, which puts strain on the kidneys.
World Kidney Day: 2023: Kidney Health for All –
Preparing for the unexpected, supporting the vulnerable!
World Kidney Day started in 2006 and has since then celebrated every second Thursday of March to raise awareness of the people. Every year, the campaign highlights a particular theme.
World Kidney Day, this year is on 9th March and aims to raise awareness of the importance of our kidneys to our overall health and to reduce the frequency and impact of kidney disease and its associated health problems worldwide.
This year’s theme is “Preparing for the unexpected, supporting the vulnerable!”
The significant impact of disastrous events, be they local like earthquake, floods, war, extreme weather or global like the COVID-19 pandemic), affects the functioning and living conditions of the community, in one or more of the following consequences: human, material, economic and environmental losses and impacts. Those affected by chronic disease, of which kidney patients represent more than 850 million people worldwide, are particularly affected by these disruptions, as the ability to access proper diagnostic services, treatments and care is greatly jeopardized.
In recent years, the COVID-19 pandemic has provided a clear example of the challenges faced by health care systems in providing essential health services to patients with Non-Communicable Diseases (NCD). The impact of COVID-19 on the health system has placed an added strain on this vulnerable population, who have had to deal with the risk of becoming infected while visiting health facilities, or indeed the suspension or cancellation of non-COVID-19 care due to health service capacity limits and lockdown policies. Health services have struggled to provide access to the ongoing incidence of new NCD cases needing diagnoses, management, and care. With no actual cure or treatment to prevent progression of CKD, the under-detected and unhindered progression of CKD to kidney failure will most certainly increase the global need for life-saving costly treatments of dialysis and transplantation.
Finally, the COVID-19 pandemic has aggravated an already insufficient global political health commitment on NCDs. NCDs are too often incorrectly perceived as due to poor lifestyle choices, with policy deficits compounded by allocation of insufficient public health funds that focus on management rather than prevention, and of only a few of the recognized NCDs – cardiovascular disease, cancer, diabetes, and chronic respiratory disease. Yet, it is estimated that 55% of the global NCD burden is attributed to diseases outside of this group, such as kidney disease. Furthermore, the burden of these four more favored NCDs is amplified in the presence of kidney disease, frequently co-existing. Public health policy that better reflects the opportunities in preventative strategies and the importance of both the magnitude and synergistic aspects of kidney disease as part of the NCD burden are urgently needed.
Therefore, preparation for unexpected events is incredibly important for kidney patients.
- Policymakers need to adopt integrated health strategies that prioritize prevention, early detection, and management of NCDs, including kidney disease.
- Health care services should provide equitable and proper access to care for chronic patients in times of emergency.
- Governments should include emergency preparedness plans in the management and detection of NCDs and favor the prevention of these conditions.
- Patients should plan for emergencies by preparing an emergency kit that includes food, water, medical supplies, and medical records.
What should we do to avoid Kidney Damage due to COVID-19?
Principles for prevention are basic and simple. One must avoid Covid-19 infection and remain safe. This will include to be vaccinated and boosted as recommended, use appropriate mask in public gathering and while traveling, keep physical distance when in public places, wash hands with soap and water and follow all the guidelines provided by CDC and World Health Organization.
Those who are already having kidney damage and are on dialysis, should continue and not miss out on their dialysis schedule.
At Asian Pacific Community for Action, we strive to ensure that everyone in Arizona is fully protected with vaccine for Covid and knows all preventive steps to avoid Covid infection and where to go for treatment and care in case they end up catching the infection and its complications. We also help people to get health insurance coverage if they do not have one and we talk in their language and assist them in all possible ways to ensure that they have health insurance at the cheapest possible way.
