Recommendations for the management of acute kidney injury and liver dysfunction management of acute kidney injury associated with COVID-19. (Pautas nacionales para la atenci..n de pacientes adultos con COVID-19.) [Spanish]

ABSTRACT

The aetiology of acute kidney injury (AKI) associated with COVID-19 is multifactorial, involving factors specific to the disease itself (viral tropism, proinflammatory cytokines, coagulopathy with thrombotic microangiopathy, rhabdomyolysis), and nonspecific factors linked to the disease itself. The diagnosis of AKI is made using the diagnostic criteria of the KDIGO definition, through frequent monitoring of creatinine and urinary output in order to carry out early detection of renal involvement. These factors act in different stages of the pre-hospital and intra-hospital evolution. There are no specific measures for prevention and treatment of acute kidney injury associated with CO-VID-19, but immunomodulatory treatment (corticosteroids) and coagulopathy (heparin) could contribute to reduce the incidence and magnitude of it. Prevention of the development of AKI is not always possible, and can be achieved by optimising therapeutic actions directed at the non-specific factors referred to below. Some of the measures to treat the non-specific factors involved in the development of acute kidney injury are also discussed in this article.