Bilateral Renal Artery Thrombosis in a Patient With COVID-19

Kidney Medicine
Osama El ShamyJaime Uribarri

Abstract

Reports of the incidence of acute kidney injury (AKI) in patients with COVID-19 have varied greatly from 0.5% to as high as 39%, with onset generally within 7 days from time of admission1. The nature of the kidney insult is acute tubular necrosis, immune cell infiltration or rhabdomyolysis as demonstrated in autopsy reports2,3. Moreover, infection with COVID-19 has been associated with coagulation abnormalities4, as well as complement-mediated generalized thrombotic microvascular injury5. These patients have been found to have high D-dimer, fibrin degradation product and fibrinogen values, an elevated INR, normal PTT and normal platelet counts. Renal artery thrombosis is a rare condition, the most common cause of which is atrial fibrillation. However, bilateral completely occlusive renal artery thrombosis is even rarer. We present a case of a patient with COVID-19 on systemic anticoagulation who presented with a serum creatinine of 6.04mg/dL requiring the initiation of kidney replacement therapy and was found to have bilateral renal artery thrombosis.

References

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Citations

Jul 7, 2021·Nature Reviews. Nephrology·Matthieu LegrandVincenzo Cantaluppi

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Methods Mentioned

BETA
bilateral renal artery aspiration

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