COVID-19 and Acute Kidney Injury

ByAnna Malkina, MD, University of California, San Francisco
Reviewed/Revised Oct 2023
VIEW PROFESSIONAL VERSION

    People with COVID-19, particularly the critically ill, may develop sudden kidney failure (acute kidney injury).

    The risk of death in people with COVID-19 increases if they also have acute kidney injury. Factors that increase the risk of developing AKI among people with COVID-19 include the following:

    • Age

    • Race (Black people are at higher risk)

    • The presence of certain other serious medical disorders, such as diabetes, high blood pressure (hypertension), and heart disease

    • The need for mechanical ventilation

    • Shock that requires medications to maintain blood pressure

    It is not clear exactly what causes acute kidney injury in people with COVID-19. Possibilities include the following:

    • Ischemia (inadequate blood supply to tissues) caused by the body's response to the virus

    • Inflammation caused by the body's response to the virus

    • Direct damage to the kidneys from the virus that causes COVID-19

    Symptoms and blood and urine test results are similar to those of acute kidney injury caused by other disorders.

    Doctors treat the acute kidney injury in COVID-19 by providing supportive care, including

    • Intravenous fluids and/or blood transfusions

    • Monitoring and correcting imbalances in electrolytes

    • If necessary, dialysis

    If dialysis of the blood is required, anticoagulants (blood thinners) are given to prevent blood clots.

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