Health experts have reported that over a quarter of coronavirus patients on ventilation suffer kidney failure. This is one of the causes of the shortage of vital equipment. Experts have warned that coronavirus can lead to acute kidney injury or AKI which is a sudden serious condition that can cause death if it is not treated immediately.

There are currently thousands of people in intensive care that need special renal support that takes over the role of the kidneys so that they can recover. The Government has warned about disruption to supplies because of the sudden increase in the number of patients, but they assure that those who are already receiving dialysis will not be affected.

What is AKI?

AKI is the sudden failure of kidney function and it can be dangerous and life-threatening. The good news is that it can be reversed with treatment. According to the Renal Association, 25% of COVID-19 patients who require treatment in an ICU and are on ventilators develop severe AKI. Meanwhile, Kidney Care UK reported that the number of patients is as high as 28%.

According to the National Kidney Foundation, around 3% to 9% of patients with confirmed COVID-19 develop an AKI. There are more than 2,000 patients admitted to intensive care with COVID-19 in Wales, England, and Northern Ireland have suffered kidney failure.

Even though COVID-19 is a respiratory disease, it still has deadly complications on a patient's vital organs. A consultant kidney specialist and president of The Renal Association, Dr. Graham Lipkin, told the BBC that the virus can be seen within the very fine structures of the kidneys.

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AKI also happens when the kidneys are damaged suddenly, usually because there is not enough blood flowing through the organs. Those who are at risk of kidney failure are those who are at higher risk of dying from COVID-19, including patients over the age of 65 and patients with preexisting health conditions like heart disease, high blood pressure, diabetes, and liver disease.

How the virus attacks the kidneys

Scientists have a theory that the virus attacks the kidneys by latching onto them. The coronavirus enters the cells of those who are infected by latching onto the ACE2 receptor, which coat cell surfaces. ACE2 is present in the lungs, which are affected by the virus. However, scientists have found high expression in parts of the kidneys, suggesting susceptibility for infection.

Dr. Josef Penninger from the University of British Columbia leads a team of international scientists and they looked at how the virus can infect blood vessels and kidneys using organoids, which are small, engineered mini-organs that replicate the real thing. The virus can infect and duplicate itself in the tissues, according to the study in the journal Cell.

The study shows the reason why severe cases of COVID-19 suffer from multi-organ failure. Even in Wuhan, where the virus originated, have found high numbers of deaths that involved kidney failure. Treatment of kidney failures requires machines that need sterile tubing sets, filters, and fluids in order to work.

Patients with severe AKI is treated with either haemofiltration or hemodialysis in the ICU, which both do the work the kidneys should be doing until they can fully recover. However, there is now a critical shortage of the material needed due to the increase in COVID-19 patients in the ICU, and the government is looking for ways to solve the ongoing problem.

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