Horm Metab Res 2022; 54(08): 510-513
DOI: 10.1055/a-1819-4822
Review

COVID-19 and Diabetic Nephropathy

1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Sophie Locke
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Wulf Tonnus
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Kristina Beer
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Anne Brucker
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Nadia Zamora Gonzalez
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Marcus Latk
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Paul Hoppenz
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Christian Hugo
1   Nephrology, Dresden University Hospital, Dresden, Germany
,
Andreas Linkermann
1   Nephrology, Dresden University Hospital, Dresden, Germany
2   Biotechnology Center, Technische Universität Dresden, Dresden, Germany
› Author Affiliations

Abstract

Diabetic nephropathy is the most common condition that requires a chronic renal replacement therapy, such as hemodialysis, peritoneal dialysis, kidney transplantation, or simultaneous kidney-pancreas transplantation. Chronic kidney disease progression, that is the loss of nephrons, which causes the continuous decline of the eGFR, underlies the pathogenesis of diabetic nephropathy. During the COVID-19 pandemic, it became clear that diabetic nephropathy is amongst the independent risk factors that predicts unfavourable outcome upon SARS-CoV2 infection. While we still lack conclusive mechanistic insights into how nephrons are rapidly lost upon SARS-CoV2 infection and why patients with diabetic nephropathy are more susceptible to severe outcomes upon SARS-CoV2 infection, here, we discuss several aspects of the interface of COVID-19 with diabetic nephropathy. We identify the shortage of reliable rodent models of diabetic nephropathy, limited treatment options for human diabetic nephropathy and the lack of knowledge about virus-induced signalling pathways of regulated necrosis, such as necroptosis, as key factors that explain our failure to understand this system. Finally, we focus on immunosuppressed patients and discuss vaccination efficacy in these and diabetic patients. We conclude that more basic science and mechanistic understanding will be required both in diabetic nephropathy as well as in host immune responses to the SARS-CoV2 virus if novel therapeutic strategies are desired.



Publication History

Received: 01 March 2022

Accepted after revision: 06 April 2022

Accepted Manuscript online:
06 April 2022

Article published online:
11 May 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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