COVID-19: Effects in Comorbidities and Special Populations

COVID-19 And Chronic Kidney Diseases

Author(s): Vikas Makkar*, Sudhir Mehta, Suman Sethi, Simran Kaur and P.M. Sohal

Pp: 181-229 (49)

DOI: 10.2174/9789815036367122010009

* (Excluding Mailing and Handling)

Abstract

The SARS-Coronavirus-19 disease has emerged as a global health challenge and has engulfed almost all countries since it was first reported in Wuhan, China. Patients with CKD have not been spared from the wrath of this pandemic and are bearing the brunt of it along with the rest of the population. Most of the patients with CKD have underlying comorbidities like diabetes and hypertension and are at an increased risk of adverse outcomes. Some of the manifestations of COVID-19 include proteinuria, hematuria, AKI, and acute CKD, requiring various forms of renal replacement therapy. Multiple mechanisms proposed for this damage include direct invasion, cytokine storm, hemodynamic derangements, and many others that are still undergoing extensive research. Since SARS COV 2 enters the cells through ACE 2 receptors, there are concerns regarding the use of ACE inhibitors and ARBs in patients already on these drugs. There are concerns regarding the use of immunosuppressants in various immune-mediated kidney diseases (postponing planned doses of methylprednisolone/cyclophosphamide/rituximab). Hemodialysis patients are exposed to potential sources of coronavirus as they have to repeatedly report to hospitals for their dialysis sessions. Measures regarding safeguarding dialysis staff from COVID -19 are contentious issues, especially in resource-limited settings. Almost all renal transplant patients are on lifelong immunosuppressive agents, making them more vulnerable to infections. Therefore, CKD patients have unique issues in the management of COVID and CKD, which we need to understand to develop protocols for the management of these problems.


Keywords: ACE2, Acute on CKD, AKI, COVID-19, COVAN, CRRT, Cytokine storm, Extracorporeal therapies, Glomerular diseases, Hematuria, Hemodialysis, Immunosuppressive therapy, Kidney diseases, Kidney transplant, Maintenance, Organ crosstalk, Pandemic, Peritoneal dialysis, Personal, Protective equipment, Proteinuria, Systemic effects, Sytosorb.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59068240 and j.to_ip >=59068240 )) and ((j.from_date <= 1739848424 and j.to_date >= 1739848424 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17609) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59068240 and j.to_ip >=59068240 )) and ((j.from_date <= 1739848424 and j.to_date >= 1739848424 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17609) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59068240 and j.to_ip >=59068240 )) and ((j.from_date <= 1739848424 and j.to_date >= 1739848424 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17609)
      580μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 3392 and `b`.`banner_from_date` <= 1739848424 and `b`.`banner_to_date` >= 1739848424 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.08msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 3392
      • 3: 1739848424
      • 4: 1739848424
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='1856b7240ac2b16ed7561f6a8c2fdb08'
      230μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    23Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        5NDQtYbBQmNiP8mU3zUQ9Kb9MvgduxyMdf9dSy4S
        uc_cart_id
        1856b7240ac2b16ed7561f6a8c2fdb08
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/17609" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/17609
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6InBkYU53ZUYybjJ4eituR1hGUUVmOVE9PSIsInZhbHVlIjoicDdvWW50cUdtaDRyK3NCaDBoVG8zcDFQN1B0eHRLTWlaQ0gzMmxZaVBaND0iLCJtYWMiOiIyMjg3Zjc0OGE1MGFkNzljN2UwOWM0YjNjNDY5ZmI5YmMxNzJmYzQxZTUwYWJhNWUwNDVhMDAzM2Q1ZTM1MTQwIiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6InBkYU53ZUYybjJ4eituR1hGUUVmOVE9PSIsInZhbHVlIjoicDdvWW50cUdtaDRyK3NCaDBoVG8zcDFQN1B0eHRLTWlaQ0gzMmxZaVBaND0iLCJtYWMiOiIyMjg3Zjc0OGE1MGFk" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Tue, 18 Feb 2025 03:13:44 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlNzUEhldVNjK3hBNmJGZjUzckJQZ1E9PSIsInZhbHVlIjoiQWFNMW5jZ1FhdnVkMU9uZnFlRlpSNDlzb0FaSUN6bVBwVkNiN0dteWV5SFI1TDdzeHdHdVhyVloxaWwxSVVtMmRXcEtpdm5yZ3gzbm51SWRzbkw1TU10cEo5aFZIekp1czBYaFhKN3BickJVSGQvYXRyRkVDeSszZnFqU3ZtWG0iLCJtYWMiOiI1OTAwMjNjN2MyOWQwOWJlMDViMDNiY2RjYThmNWM2NjlhMzMzMzNlMjExN2ZiNTZhMjIzNDIzY2RmNDIyNjAwIiwidGFnIjoiIn0%3D; expires=Thu, 20 Feb 2025 15:13:44 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IlNzUEhldVNjK3hBNmJGZjUzckJQZ1E9PSIsInZhbHVlIjoiQWFNMW5jZ1FhdnVkMU9uZnFlRlpSNDlzb0FaSUN6bVBwVkNiN0dteWV5SFI1TDdzeHdHdVhyVloxaWwxSVVtMmRXcEtpd" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlhFOXBJMWcvdTZGMHpHd1M1N1ZxRWc9PSIsInZhbHVlIjoibXg0MVNZV2pZeUhmOE4vNlBCbWF1QUZteGgwam5veVhJL1ZVNUx2Mk5CU29VMW9aM21OdXpKYXVNcmpHRlBLNUpyYUhpaWRiY014Rm0wY0hOcU13Z1R6TVBJWjE2UUh2YUpyRmdQTDRSRXBNZ1M5QWJvUzJ4b3doQ09ISUw3QUMiLCJtYWMiOiI0ZDhhN2NiYzRlYTcxYTUwMjYwYWNhNThjN2U5YzA2OWZhZDRlZGI0MTVmZGZiMDBlYmNkNTk2Mzc4NmY4ZDM1IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IlhFOXBJMWcvdTZGMHpHd1M1N1ZxRWc9PSIsInZhbHVlIjoibXg0MVNZV2pZeUhmOE4vNlBCbWF1QUZteGgwam5veVhJL1ZVNUx2Mk5CU29VMW9aM21OdXpKYXV" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlNzUEhldVNjK3hBNmJGZjUzckJQZ1E9PSIsInZhbHVlIjoiQWFNMW5jZ1FhdnVkMU9uZnFlRlpSNDlzb0FaSUN6bVBwVkNiN0dteWV5SFI1TDdzeHdHdVhyVloxaWwxSVVtMmRXcEtpdm5yZ3gzbm51SWRzbkw1TU10cEo5aFZIekp1czBYaFhKN3BickJVSGQvYXRyRkVDeSszZnFqU3ZtWG0iLCJtYWMiOiI1OTAwMjNjN2MyOWQwOWJlMDViMDNiY2RjYThmNWM2NjlhMzMzMzNlMjExN2ZiNTZhMjIzNDIzY2RmNDIyNjAwIiwidGFnIjoiIn0%3D; expires=Thu, 20-Feb-2025 15:13:44 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IlNzUEhldVNjK3hBNmJGZjUzckJQZ1E9PSIsInZhbHVlIjoiQWFNMW5jZ1FhdnVkMU9uZnFlRlpSNDlzb0FaSUN6bVBwVkNiN0dteWV5SFI1TDdzeHdHdVhyVloxaWwxSVVtMmRXcEtpd" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlhFOXBJMWcvdTZGMHpHd1M1N1ZxRWc9PSIsInZhbHVlIjoibXg0MVNZV2pZeUhmOE4vNlBCbWF1QUZteGgwam5veVhJL1ZVNUx2Mk5CU29VMW9aM21OdXpKYXVNcmpHRlBLNUpyYUhpaWRiY014Rm0wY0hOcU13Z1R6TVBJWjE2UUh2YUpyRmdQTDRSRXBNZ1M5QWJvUzJ4b3doQ09ISUw3QUMiLCJtYWMiOiI0ZDhhN2NiYzRlYTcxYTUwMjYwYWNhNThjN2U5YzA2OWZhZDRlZGI0MTVmZGZiMDBlYmNkNTk2Mzc4NmY4ZDM1IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IlhFOXBJMWcvdTZGMHpHd1M1N1ZxRWc9PSIsInZhbHVlIjoibXg0MVNZV2pZeUhmOE4vNlBCbWF1QUZteGgwam5veVhJL1ZVNUx2Mk5CU29VMW9aM21OdXpKYXV" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "5NDQtYbBQmNiP8mU3zUQ9Kb9MvgduxyMdf9dSy4S" "uc_cart_id" => "1856b7240ac2b16ed7561f6a8c2fdb08" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/17609" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-18 03:13:44GET/chapter/176091121925