sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20230401sibmed-1151Research ArticleОБЗОРЫREVIEWSМеханизмы развития почечного повреждения у пациентов с новой коронавирусной инфекцией (обзор литературы)Mechanisms of renal damage in patients with new coronavirus infection (literature review)https://orcid.org/0000-0002-2000-3562УткинаЕ. В.UtkinaE. V.

Уткина Екатерина Владимировна

650056, г. Кемерово, ул. Ворошилова, 22а

Ekaterina V. Utkina

650056, Kemerovo, Voroshilova st., 22a

goll1997.2011@mail.ruНоваковскаяВ. В.NovakovskayaV. V.

Новаковская Виктория Викторовна

650000, г. Кемерово, просп. Октябрьский, 22

Victoria V. Novakovskaya

650066, Kemerovo, Oktyabrsky ave., 22

vikibox@yandex.ruЕгороваМ. В.EgorovaM. V.

Егорова Марина Викторовна, к.м.н.

650056, г. Кемерово, ул. Ворошилова, 22а

650000, г. Кемерово, просп. Октябрьский, 22

Marina V. Egorova, candidate of medical sciences

650056, Kemerovo, Voroshilova st., 22a

650066, Kemerovo, Oktyabrsky ave., 22

marina-egorova-85@bk.ruhttps://orcid.org/0000-0003-2139-5446ФоминаН. В.FominaN. V.

Фомина Наталья Викторовна, д.м.н.

650056, г. Кемерово, ул. Ворошилова, 22а

650000, г. Кемерово, просп. Октябрьский, 22

Natalya V. Fomina, doctor of medical sciences

650056, Kemerovo, Voroshilova st., 22a

650066, Kemerovo, Oktyabrsky ave., 22

natafomin@mail.ruhttps://orcid.org/0000-0003-2139-5446ЧесноковаЛ. Д.ChesnokovaL. D.

Чеснокова Людмила Данииловна

650056, г. Кемерово, ул. Ворошилова, 22а

650000, г. Кемерово, просп. Октябрьский, 22

Lyudmila D. Chesnokova

650056, Kemerovo, Voroshilova st., 22a

650066, Kemerovo, Oktyabrsky ave., 22

lches48@mail.ruКемеровский государственный медицинский университет Минздрава РоссииРоссияKemerovo State Medical University of Minzdrav of RussiaRussian FederationКемеровская областная клиническая больница им. С.В. БеляеваРоссияKemerovo Regional Clinical Hospital n.a. S.V. BelyaevRussian FederationКемеровский государственный медицинский университет Минздрава России; Кемеровская областная клиническая больница им. С.В. БеляеваРоссияKemerovo State Medical University of Minzdrav of Russia; Kemerovo Regional Clinical Hospital n.a. S.V. BelyaevRussian Federation202328082023434614Copyright © Уткина Е.В., Новаковская В.В., Егорова М.В., Фомина Н.В., Чеснокова Л.Д., 20232023Уткина Е.В., Новаковская В.В., Егорова М.В., Фомина Н.В., Чеснокова Л.Д.Utkina E.V., Novakovskaya V.V., Egorova M.V., Fomina N.V., Chesnokova L.D.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/1151

Каждый четвертый человек в мире в настоящее время в той или иной степени имеет проблемы с почками. Известно, что новая коронавирусная инфекция (COVID-19) является в первую очередь респираторным заболеванием, но почки – орган-мишень. Коронавирус тропен к почечной ткани за счет нахождения в органе РНК ангиотензинпревращающего фермента типа 2 и трансмембранной сериновой протеазы 2, которые считаются мишенью этого вируса. Наличие любой стадии почечной недостаточности является независимым неблагоприятным фактором риска заражения коронавирусной инфекцией и приводит к высоким частоте госпитализации в стационары и уровню смертности. Повреждение почек вызвано разнообразными патогенетическими механизмами: прямое цитопатическое действие вируса на их структуры (в почечном тельце – подоциты, мезангиальные клетки, в сосудистом клубочке – эндотелий капилляров, в проксимальных канальцах – эпителиальные клетки), цитокиновый шторм, поражение ренин-ангиотензин-альдостероновой системы, иммунотромбоз. У многих пациентов с подтвержденной коронавирусной инфекцией уже с первых дней болезни лабораторно отмечаются существенные изменения в анализе мочи (гематурия, протеинурия) и повышение уровня креатинина в сыворотке крови. Один из основных факторов риска смертности – развитие острого почечного повреждения. Необходимы дополнительные исследования точного воздействия SARS-CoV-2 на почки. Понимание основных патогенетических путей их повреждения при COVID-19 необходимо для разработки стратегий и эффективных методов лечения.

One in four people in the world currently has kidney problems to varying degrees. It is known that the new coronavirus infection (COVID-19) is primarily a respiratory disease, but the kidneys are the target organ. Coronavirus is tropic to renal tissue due to the presence in the organ of the angiotensin converting enzyme type 2 and transmembrane serine protease 2, which are considered the target of this virus. The presence of any stage of renal insufficiency is an independent adverse risk factor for coronavirus infection and results in high hospitalization rates in hospitals and a mortality rate. Kidney damage is caused by a variety of pathogenetic mechanisms: direct cytopathic effect of the virus on their structure (in the kidney body - podocytes, mesangial cells, in the vascular glomerulus - endothelium of capillaries, in the proximal tubules - epithelial cells); cytokine storm; damage to the renin-angiotensin-aldosterone system; immunothrombosis. In many patients with confirmed coronavirus infection, significant changes in urine analysis (hematuria, proteinuria) and an increase in serum creatinine levels have been observed in the laboratory since the first days of the disease. One of the main risk factors for mortality is the development of acute renal injury. More research is needed on the exact effects of SARS-CoV-2 on the kidneys. Understanding the main pathogenetic pathways of kidney damage in COVID-19 is necessary for the development of strategies and the development of effective treatment methods.

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The authors declare that there are no conflicts of interest present.