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Coronavirus may cause acute kidney damage in one third of hospital cases

Just another reason to keep the virus out until things improve.

Acute Kidney Injury Seen in Most Severe COVID-19 Cases

— One third of all hospitalized cases also affected in NYC data

New data from two health systems in New York City — where hospitals struggled to keep up with dialysis demands as they were flooded with COVID-19 patients — detailed a high rate of acute kidney injury among infected patients.

In the first 1,000 patients with COVID-19 at NewYork-Presbyterian/Columbia University Irving Medical Center, 33.9% developed acute kidney injury. Of the 236 who ended up in the ICU, 78% developed AKI, Ruijun Chen, MD, and colleagues reported in The BMJ.

In another study of 5,500 patients the rate was 36% of those hospitalized, and 89% of those in ICU on ventilators. Quite a few of these people went on to die, so, to put it bluntly, they wont be in need of dialysis or further care. But some part of the population in a post corona world will need ongoing care and won’t be able to work at their former level.

At least one person in the US likely died because there wasn’t enough dialysis equipment.

Docs are not sure if the kidney injury is from the virus or a side effect of the treatments. As we get better at treating this we may prevent this damage happening. Though, any disease involving mass clotting could cause damage in most organs, some of which can be repaired, but some of which will cause scarring that may be permanent. If Coronavirus is like a stroke-machine, the cognitive damage may be significant.

An Overlooked, Possibly Fatal Coronavirus Crisis

By Reed Abelson, Sheri Fink, Nicholas Kulish and Katie Thomas, New York Times.

April 18th, 2020

“Nothing like this has ever been seen in terms of the number of people needing kidney replacement therapy,” [said Dr. David S. Goldfarb, chief of nephrology at the New York campus of the New York Harbor VA Health Care System].

Outside of New York, the growing demand nationwide for kidney treatments is fraying the most advanced care units in hospitals at emerging hot spots like Boston, Chicago, New Orleans and Detroit.

Kidney specialists now estimate that 20 percent to 40 percent of I.C.U. patients with the coronavirus suffered kidney failure and needed emergency dialysis, according to Dr. Alan Kliger, a nephrologist at Yale University School of Medicine.

One doctor in New York City, who was not authorized to speak publicly, recalled anguished exchanges with other physicians last week. “You’re yelling at them. You’re telling them you don’t have a dialysis machine to give them. You hear the intensity and the desperation in the other person’s voice,” the doctor said. “My job was hell.”

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