The coronavirus 2019 (COVID-19) pandemic has caused a huge impact on health and economic issues. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes cellular damage by entry mediated by the angiotensin-converting enzyme 2 of the host cells and its conjugation with spike proteins of SARS-CoV-2. Beyond airway infection and acute respiratory distress syndrome, acute kidney injury is common in SARS-CoV-2-associated infection, and acute kidney injury (AKI) is predictive to multiorgan dysfunction in SARS-CoV-2 infection. Beyond the cytokine storm and hemodynamic instability, SARS-CoV-2 might directly induce kidney injury and cause histopathologic characteristics, including acute tubular necrosis, podocytopathy and microangiopathy. The expression of apparatus mediating SARS-CoV-2 entry, including angiotensin-converting enzyme 2, transmembrane protease serine 2 (TMPRSS2) and a disintegrin and metalloprotease 17 (ADAM17), within the renal tubular cells is highly associated with acute kidney injury mediated by SARS-CoV-2. Both entry from the luminal and basolateral sides of the renal tubular cells are the possible routes for COVID-19, and the microthrombi associated with severe sepsis and the dysregulated renin–angiotensin–aldosterone system worsen further renal injury in SARS-CoV-2-associated AKI. In the podocytes of the glomerulus, injured podocyte expressed CD147, which mediated the entry of SARS-CoV-2 and worsen further foot process effacement, which would worsen proteinuria, and the chronic hazard induced by SARS-CoV-2-mediated kidney injury is still unknown. Therefore, the aim of the review is to summarize current evidence on SARS-CoV-2-associated AKI and the possible pathogenesis directly by SARS-CoV-2.
【저자키워드】 COVID-19, ACE2, TMPRSS2, Acute kidney injury, CD147, ADAM17, 【초록키워드】 SARS-CoV-2, coronavirus, pandemic, Pathogenesis, SARS-COV-2 infection, Infection, Sepsis, protease, angiotensin-converting enzyme 2, Spike protein, airway, Kidney injury, Health, AKI, Characteristics, Coronavirus 2019, expression, podocyte, acute respiratory distress, Evidence, Multiorgan dysfunction, Injury, microthrombi, Predictive, host cell, acute tubular necrosis, acute respiratory syndrome, SARS-CoV-2 entry, syndrome, transmembrane, cellular damage, renal, hemodynamic instability, basolateral side, serine 2, caused, expressed, induce, cause, dysregulated, entry of SARS-CoV-2, renal tubular cell, the cytokine storm, 【제목키워드】 novel, evidence of,