ACHADOS HISTOPATOLÓGICOS RENAIS DE INDIVÍDUOS TRANSPLANTADOS RENAIS COM HIPERTENSÃO ARTERIAL SISTÊMICA QUE CONTRAÍRAM SARS-COV-2: UMA REVISÃO SISTEMÁTICA
Keywords:
SARS-CoV-2, Biopsy, Renal allograft, Systemic arterial hypertensionAbstract
The prevalence of chronic kidney disease continues to increase worldwide, with kidney transplantation being the most effective treatment for patients with end-stage of chronic kidney disease. With the COVID-19 pandemic, concern about the deleterious effect of SARS-CoV-2 on the kidneys of kidney transplant recipients has become the focus of several studies. Thus, this study aimed to construct a systematic review of histopathological findings in patients with a history of systemic arterial hypertension and renal allograft who underwent renal biopsy due to SARS-CoV-2. For this, a bibliographic survey was carried out from January 2020 to December 2023, based on the PRISMA protocol, in the PubMed and Science Direct databases to collect clinical and epidemiological data. A total of 572 patients were identified, of which 68% had a history of hypertension, with mortality from COVID-19 being 26%. In 94% of cases, histopathological examination was performed due to clinical suspicion of renal allograft dysfunction. After renal biopsy, the histopathological diagnosis was acute kidney injury in 87% of cases. The main histopathological findings were thrombotic microangiopathy, interstitial inflammation, and collapsing glomerulopathy. The renal pathophysiology of hypertension is consistent with these histopathological findings, although acute kidney injury is mainly related to SARS-CoV-2 infection. Therefore, considering the high prevalence of hypertension among kidney transplant patients, it is understandable how serious it is for these patients to acquire COVID-19, since the virus can lead to renal allograft dysfunction.
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