CoV-KIDNEY PROJECT: epidemiological, laboratory, anatomopathological and atmospheric conditions analysis of kidney injury in COVID-19 infection

Abstract

The project aims to conduct an epidemiological, laboratory, anatomopathological and environmental analysis of patients infected with COVID-19 who develop acute kidney injury (ARI) and / or present urinary changes such as hematuria, albuminuria and / or proteinuria. The definition of IRA will follow the KDIGO criteria. In patients who evolve with the need for dialysis, the following variables will be evaluated: indication, the dialysis method and the time needed for renal replacement therapy and will be compared with a control group, made up of patients with ARI and ARDS (respiratory distress syndrome) adult dialysis dependent paired by SOFA. Coagulation analysis, patency of filters and catheters will also be compared to this control group. These variables will be correlated with length of stay, mortality and recovery or not of renal function. Renal changes will be correlated with the possible comorbidities of patients, age, respiratory severity, need for vasoactive drugs, secondary bacterial infection, the patient's place of residence and the influence of climatic conditions in the greater São Paulo. We know that climatic conditions and air quality are of significant importance in the incidence and prevalence of diseases. It is known that there is a higher incidence of kidney disease in environments with a high level of particulate matter. Patients who have kidney changes during hospitalization and are discharged will be followed up at the nephrology clinic for a period of one year to assess whether or not their kidney function is recovering, with a study of progression markers of kidney disease and senescence (urinary electrolytes), albuminuria, proteinuria, NGAL, klotho, MCP-1, ²-galactosidase, p21 and p16). The functional reserve will also be assessed. In renal tissue, from patients who die, histology will be studied with evaluation of necrosis and apoptosis, inflammation markers such as neutrophils, macrophages and lymphocytes, senescence markers such as p21, p-16, and Klotho, and the expression of the enzyme of conversion of angiotensin 2 (ACE2). (AU)