Abstract
Traditionally collapsing glomerulopathy (CG) is associated with medications, autoimmune disease, viral infection and the APOL1 gene variant seen in blacks/African Americans. Most reported cases of acute kidney injury (AKI) in COVID-19 infected individuals have been in individuals without prior CKD. In this report, we present a 49-year-old African American female with a past medical history of chronic kidney disease (CKD) stage 4, hypertension, type 2 diabetes mellitus, recent COVID-19 infection, and a repeat positive blood test for COVID-19 more than 21 days after the initial result, who presented with an AKI on CKD. Renal biopsy revealed a collapsing glomerulopathy. She was started on hemodialysis and did not receive immunosuppressive therapy due to the advanced scaring seen on the renal biopsy. Concerning the pathophysiology of COVID-19-associated CG, researchers have postulated different mechanisms such as a direct cytopathic effect of the virus on podocytes, immune dysregulation, and fluid imbalance. This is one of a few cases of AKI on CKD due to CG related to COVID-19. The mechanism of CG was, however, unclear. Currently, there is no specific interventions to prevent the development of CG in patients with COVID-19 infection. Further studies should investigate measures to prevent the development of CG.
Keywords: Acute; COVID-19; Collapsing; Glomerulopathy; Injury; Kidney.
【저자키워드】 COVID-19, kidney, glomerulopathy, Acute, Collapsing, Injury, 【초록키워드】 viral infection, therapy, variant, Infection, Diabetes Mellitus, Type 2 diabetes mellitus, Intervention, Acute kidney injury, Chronic kidney disease, diabetes, medications, virus, hypertension, kidney, Autoimmune disease, Hemodialysis, AKI, COVID-19 infection, pathophysiology, female, Kidney disease, glomerulopathy, renal biopsy, African American, mechanism, Blood, blood test, immunosuppressive therapy, Cytopathic effect, Collapsing, Injury, APOL1, immunosuppressive, CKD, immune dysregulation, dysregulation, medical history, Podocytes, infected individuals, individual, Americans, Stage, measure, renal, positive, past medical history, MOST, researcher, Prevent, fluid imbalance, initial, reported, receive, COVID-19 infected individual, patients with COVID-19, type 2 diabete, 【제목키워드】 Case report, presenting,