| 1 | Native and transplant kidney histopathological manifestations in association with COVID-19 infection: A systematic review显示文摘BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can result in clinically significant multi-system disease including involvement in the kidney.The underlying histopathological processes were unknown at the start of the pandemic.As case reports and series have been published describing the underlying renal histopathology from kidney biopsies,we have started to gain an insight into the renal manifestations of this novel disease.AIM To provide an overview of the current literature on the renal histopathological features and mechanistic insights described in association with coronavirus disease 2019(COVID-19)infection.METHODS A systematic review was performed by conducting a literature search in the following websites-‘PubMed’,‘Web of Science’,‘Embase’and‘Medline-ProQuest’with the following search terms-“COVID-19 AND kidney biopsy”,“COVID-19 AND renal biopsy”,“SARS-CoV-2 AND kidney biopsy”and“SARS-CoV-2 AND renal biopsy”.We have included published data up until February 15,2021,which includes kidney biopsies(native,transplant and postmortem)from patients with COVID-19.Data on clinical presentation,histopathological features,management and outcome was extracted from the reported studies.RESULTS The total number of biopsies reported on here is 288,of which 189 are postmortem,84 native and 15 transplants.The results are varied and show underlying pathologies ranging from collapsing glomerulopathy and acute tubular injury(ATI)to anti-nuclear cytoplasmic antibody associated vasculitis and pigment nephropathy.There was variation in the specific treatment used for the various renal conditions,which included steroids,hydroxychloroquine,eculizumab,convalescent plasma,rituximab,anakinra,cyclophosphamide and renal replacement therapy,amongst others.The pathological process which occurs in the kidney following COVID-19 infection and leads to the described biopsy findings has been hypothesized in some conditions but not others(for example,sepsis related hypoperfusion for ATI).It is important to note that this represents a very small minority of the total number of cases of COVID-19 related kidney disease,and as such there may be inherent selection bias in the results described.Further work will be required to determine the pathogenetic link,if any,between COVID-19 and the other renal pathologies.CONCLUSION This report has clinical relevance as certain renal pathologies have specific management,with the implication that kidney biopsy in the setting of renal disease and COVID-19 should be an early consideration,dependent upon the clinical presentation. | Vishnu Jeyalan Joshua Storrar Henry H L Wu Arvind Ponnusamy Smeeta Sinha Philip A Kalra Rajkumar Chinnadurai | 2021 | World Journal of Transplantation2021，11，11： | 1 |
| 2 | Hepatocardiorenal syndrome in liver cirrhosis:Recognition of a new entity?显示文摘Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome(HRS),outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of pathophysiological mechanisms directly affecting the kidneys in this context.In the absence of established heart disease,cirrhotic cardiomyopathy may occur more frequently in those with liver cirrhosis and kidney disease.It is a specific form of cardiac dysfunction characterized by blunted contractile responsiveness to stress stimuli and altered diastolic relaxation with electrophysiological abnormalities.Despite the clinical description of these potential cardiac-related complications of the liver,the role of the heart has traditionally been an overlooked aspect of circulatory dysfunction in HRS.Yet from a physiological sense,temporality(prior onset)of cardiorenal interactions in HRS and positive effects stemming from portosystemic shunting demonstrated an important role of the heart in the development and progression of kidney dysfunction in cirrhotic patients.In this review,we discuss current concepts surrounding how the heart may influence the development and progression of HRS,and the role of systemic inflammation and endothelial dysfunction causing circulatory dysfunction within this setting.The temporality of heart and kidney dysfunction in HRS will be discussed.For a subgroup of patients who receive portosystemic shunting,the dynamics of cardiorenal interactions following treatment is reviewed.Continued research to determine the unknowns in this topic is anticipated,hopefully to further clarify the intricacies surrounding the liver-heart-kidney connection and improve strategies for management. | Henry H L Wu Amina Rakisheva Arvind Ponnusamy Rajkumar Chinnadurai | 2024 | World Journal of Gastroenterology2024，30，2： | 0 |
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