Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade
The renin-angiotensin system plays a very critical role in hypertension, diabetes, and kidney and heart diseases. The blockade of the renin-angiotensin system results in the prevention of progression of renal and cardiac damage. There have been controversial hypotheses raised regarding the safety of...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2020/8811931 |
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| author | Avantika Chenna Venu Madhav Konala Subhasish Bose Sasmit Roy Bhaskar Reddy Madhira Vijay Gayam Srikanth Naramala Sreedhar Adapa |
| author_facet | Avantika Chenna Venu Madhav Konala Subhasish Bose Sasmit Roy Bhaskar Reddy Madhira Vijay Gayam Srikanth Naramala Sreedhar Adapa |
| author_sort | Avantika Chenna |
| collection | DOAJ |
| description | The renin-angiotensin system plays a very critical role in hypertension, diabetes, and kidney and heart diseases. The blockade of the renin-angiotensin system results in the prevention of progression of renal and cardiac damage. There have been controversial hypotheses raised regarding the safety of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in COVID-19 (coronavirus disease 2019). We present the case series of four patients (2 men and 2 women; 1 Caucasian and 3 African Americans; two survived and two died) with confirmed COVID-19, presenting with respiratory symptoms and acute kidney injury, who have been on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Membrane-bound angiotensin-converting enzyme 2 (ACE2) has been implicated as the gateway for viral entry into the human cell in causing the infection. The factors contributing to acute kidney injury are diuretics, iodinated contrast administration, hemodynamic instability apart from ACE inhibitors, and angiotensin receptor blockers. The ACE inhibitors and ARBs were stopped in these patients due to acute kidney injury. We also discussed the role of ACE2 and the renin-angiotensin system (RAS) blockade in patients with COVID-19 infection along with pathogenesis. |
| format | Article |
| id | doaj-art-b5b371f5b67142e4b9ba8a85c7f137e6 |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-b5b371f5b67142e4b9ba8a85c7f137e62025-02-03T06:46:55ZengWileyCase Reports in Nephrology2090-66412090-665X2020-01-01202010.1155/2020/88119318811931Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System BlockadeAvantika Chenna0Venu Madhav Konala1Subhasish Bose2Sasmit Roy3Bhaskar Reddy Madhira4Vijay Gayam5Srikanth Naramala6Sreedhar Adapa7Department of Internal Medicine, Division of Nephrology, Phobe Putney Memorial Hospital, Medical College of Georgia, 417 W 3rd Avenue, Albany 31701, GA, USADepartment of Internal Medicine, Division of Medical Oncology, Ashland Bellefonte Cancer Center, 122 St Christopher Dr, Ashland 41169, KY, USALynchburg Nephrology Physicians, Lynchburg, VA, USALynchburg Nephrology Physicians, Lynchburg, VA, USAFellow in Hematology and Oncology, Sunny Upstate Medical University, Syracuse, NY, USADepartment of Medicine, Interfaith Medical Center, Brooklyn, NY, USADepartment of Internal Medicine, Division of Rheumatology, Adventist Medical Center, Hanford 93230, CA, USADepartment of Internal Medicine, Division of Nephrology, Adventist Medical Center, Hanford 93230, CA, USAThe renin-angiotensin system plays a very critical role in hypertension, diabetes, and kidney and heart diseases. The blockade of the renin-angiotensin system results in the prevention of progression of renal and cardiac damage. There have been controversial hypotheses raised regarding the safety of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in COVID-19 (coronavirus disease 2019). We present the case series of four patients (2 men and 2 women; 1 Caucasian and 3 African Americans; two survived and two died) with confirmed COVID-19, presenting with respiratory symptoms and acute kidney injury, who have been on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Membrane-bound angiotensin-converting enzyme 2 (ACE2) has been implicated as the gateway for viral entry into the human cell in causing the infection. The factors contributing to acute kidney injury are diuretics, iodinated contrast administration, hemodynamic instability apart from ACE inhibitors, and angiotensin receptor blockers. The ACE inhibitors and ARBs were stopped in these patients due to acute kidney injury. We also discussed the role of ACE2 and the renin-angiotensin system (RAS) blockade in patients with COVID-19 infection along with pathogenesis.http://dx.doi.org/10.1155/2020/8811931 |
| spellingShingle | Avantika Chenna Venu Madhav Konala Subhasish Bose Sasmit Roy Bhaskar Reddy Madhira Vijay Gayam Srikanth Naramala Sreedhar Adapa Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade Case Reports in Nephrology |
| title | Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade |
| title_full | Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade |
| title_fullStr | Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade |
| title_full_unstemmed | Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade |
| title_short | Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade |
| title_sort | acute kidney injury in a case series of patients with confirmed covid 19 coronavirus disease 2019 role of angiotensin converting enzyme 2 and renin angiotensin system blockade |
| url | http://dx.doi.org/10.1155/2020/8811931 |
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