Diabetic Kidney Disease and Covid-19

ABSTRACT

Diabetic kidney disease (DKD) is the leading cause of morbidity and mortality in patients with diabetes. Moreover, chronic kidney disease (CKD) is associated with cardiovascular disease (CVD) in these patients. Of interest, DKD patients express a chronic systemic inflammation that contributes to the immunosuppressed state that accounts for infectious complications. Hospital admissions and mortality from the coronavirus disease 2019 (COVID-19) pandemic are spreading throughout the world. Risk factors for severe COVID-19 include diabetes, CKD, and CVD. In susceptible patients, preexisting immune deficiency and other chronic conditions can promote the well-known "cytokine storm” observed in COVID-19. As with many other organs, the kidneys are susceptible to be affected since they express the ACE2 receptor (SARS-CoV-2 cell receptor). Beyond the reported acute kidney involvement, growing evidence showed that CKD progression might be accelerated due to the associated chronic endothelial dysfunction observed in COVID-19 patients. This chapter explores the existing evidence regarding the COVID-19 pandemic crashing with the old diabetes pandemic. Likewise, a special approach to the possible benefits of antidiabetic and other drugs is discussed. © Springer Nature Switzerland AG 2014, 2022.