| Summary: | Coronavirus disease 2019 (COVID-2019) is a viral infection that mainly causes pulmonary infection but mortality usually occurred in patients have comorbidities, such as chronic kidney disease (CKD) that accounts for over 20% of mortalities, morbid obesity, immunosuppression, diabetes mellitus, hypertension, and cancer. Also, the incidence of acute kidney failure reported 5-10% in outpatient series and up to 50% in patients that need to be admitted to the intensive care unit. It is important to know that acute kidney injury (AKI) is associated with increased mortality, so this essay is going to review possible mechanisms that result in AKI. Based on the multifactorial mechanism of AKI, we should have considered probable causes of AKI and act in a stepwise manner to tackle these mechanisms and improve the ultimate prognosis of patients. Although most of the measures are supportive, in some patients such as severely ill cases cytokine storm may be attributed to the severity of symptoms, so immunomodulatory treatments could be considered to decrease AKI and consequently mortality. Among hypotheses that propose AKI; pre-renal and direct renal involvement by a virus are discussed in detail.
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