COVID-19 Hastalığında Akut Böbrek Hasarı
Özet
SARS-CoV-2 virüsünün ACE-2 reseptörlerini kullanarak böbreklerde doğrudan ve sitokin fırtınası gibi mekanizmalarla dolaylı hasara yol açması, COVID-19 hastalarında akut böbrek hasarı (ABH) insidansını ve mortalite riskini önemli ölçüde artırmaktadır. Özellikle ileri yaş, erkek cinsiyet ve diyabet veya hipertansiyon gibi ek hastalığı olanlarda daha ağır seyreden bu klinik tabloda, proteinüri ve hematüri gibi bulgular yaygın olarak gözlenmektedir. Tedavi yönetiminde hemodinamik izlem, nefrotoksik maddelerden kaçınma ve gerekli durumlarda sürekli renal replasman tedavisi (CRRT) gibi yöntemlerle böbrek fonksiyonlarının korunması kritik önem taşımaktadır.
The SARS-CoV-2 virus, by utilizing ACE-2 receptors, causes kidney damage through both direct cytopathic effects and indirect mechanisms like cytokine storms, significantly increasing the incidence of acute kidney injury (AKI) and mortality risk in COVID-19 patients. Clinical presentations such as proteinuria and hematuria are commonly observed, particularly in older patients, males, and those with comorbidities like diabetes or hypertension where the disease tends to be more severe. In treatment management, preserving renal function through hemodynamic monitoring, avoidance of nephrotoxic agents, and the use of continuous renal replacement therapy (CRRT) when necessary is critically important.
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