Pathomorphological features of the kidneys in patients with chronic kidney disease on dialysis with COVID-19 infection

The current study aimed to investigate the pathomorphology of the kidneys in patients with chronic kidney disease (CKD) on dialysis infected with COVID-19, focusing on structural changes and their correlation with the severity of the infection. The study included autopsy data from patients infected with COVID-19 who had been undergoing renal replacement therapy for 6 months to 1 year and died at the Zangiota Republican Specialized Center in 2022. The study was conducted using kidney biopsy samples. Morphological analysis included macroscopic examination, histological, and microscopic methods to identify signs of inflammation, fibrosis, and thrombosis. The results showed that kidneys of patients with COVID-19 were enlarged, with a granular surface and subcapsular hemorrhages. Histological examination revealed necrotic nephrosis, tubulointerstitial fibrosis, significant vascular involvement, and vacuolar degeneration of the tubules. Thrombosis of vessels and ischemic infarctions were frequently observed, correlating with the severity of COVID-19. The formation of focal segmental glomerulosclerosis, associated with chronic inflammation, was a notable feature. COVID-19 induces significant pathological changes in the kidneys of patients with CKD on dialysis, aggravating the course of chronic kidney failure. It is concluded that there is a need for early detection and prevention of renal complications in patient with COVID-19.