Ambulatory management of prerenal acute kidney injury associated with COVID-19 infection: Case report.

Abstract

Introduction. Acute kidney injury (AKI) associated with COVID-19 has different incidences. It occurs in 20-40% of ICU patients, 50-60% of patients requiring mechanical ventilation and 7-9% of patients with outpatient management. Objective. To present a case of ambulatory management of AKI associated with COVID-19 to demonstrate that control of pathophysiological variables allows adequate recovery of renal function. Clinical case. A 62-year-old male, with a history of DM2 and hypertension, treated, who reported persistent fever, dry cough, subsequently productive, oxygen saturation at 82%, dyspnea and anosmia; also, decreased urine volume. COVID-19 was confirmed by PCR and simple chest CT, CORADS-5 classification. In the laboratory control, leukocytosis, elevated azooses and increased BUN/Cr ratio and EGO with urinary density of 1.015 were found, giving a diagnosis of prerenal AKI. Treatment was adjusted, focusing on AKI, suspending nephrotoxic drugs, control of hemodynamic status, glycemia and respiratory status with supplemental oxygen. He presented progressive improvement of urinary volumes, glycemia control, decrease of azoados and BUN/Cr ratio, and lower supplemental oxygen demand. Conclusions. Because of the absence of specific treatments, treatment aimed at controlling the pathophysiological variables of systemic inflammatory response syndrome (SIRS) involved in the development of prerenal AKI provides adequate life support that allows for recovery and a better prognosis.