{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:55:44Z","timestamp":1792659344405,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2020,9]]},"abstract":"\n Significance Statement<\/jats:title>\n AKI is a known complication of severe COVID-19. Autopsy series of patients who died with COVID-19 reported acute tubular necrosis in the kidney, and a few patient reports noted the presence of collapsing glomerulopathy in patients with COVID-19. The authors describe clinical and kidney histopathologic findings for ten hospitalized patients with COVID-19 and AKI who underwent kidney biopsy. All patients had proteinuria, and eight required dialysis. Biopsy samples showed varying degrees of acute tubular necrosis in all patients; one patient also had associated myoglobin cast nephropathy. Pathologic analysis of biopsied kidneys showed no immunohistochemical evidence of severe acute respiratory syndrome coronavirus 2, and ultrastructural examination found no viral particles. This case series reveals acute tubular necrosis as the most common kidney biopsy finding in patients with COVID-19 and severe AKI.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Reports show that AKI is a common complication of severe coronavirus disease 2019 (COVID-19) in hospitalized patients. Studies have also observed proteinuria and microscopic hematuria in such patients. Although a recent autopsy series of patients who died with severe COVID-19 in China found acute tubular necrosis in the kidney, a few patient reports have also described collapsing glomerulopathy in COVID-19.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We evaluated biopsied kidney samples from ten patients at our institution who had COVID-19 and clinical features of AKI, including proteinuria with or without hematuria. We documented clinical features, pathologic findings, and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Our analysis included ten patients who underwent kidney biopsy (mean age: 65 years); five patients were black, three were Hispanic, and two were white. All patients had proteinuria. Eight patients had severe AKI, necessitating RRT. All biopsy samples showed varying degrees of acute tubular necrosis, and one patient had associated widespread myoglobin casts. In addition, two patients had findings of thrombotic microangiopathy, one had pauci-immune crescentic GN, and another had global as well as segmental glomerulosclerosis with features of healed collapsing glomerulopathy. Interestingly, although the patients had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by RT-PCR, immunohistochemical staining of kidney biopsy samples for SARS-CoV-2 was negative in all ten patients. Also, ultrastructural examination by electron microscopy showed no evidence of viral particles in the biopsy samples.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The most common finding in our kidney biopsy samples from ten hospitalized patients with AKI and COVID-19 was acute tubular necrosis. There was no evidence of SARS-CoV-2 in the biopsied kidney tissue.<\/jats:p>\n <\/jats:sec>","DOI":"10.1681\/asn.2020050699","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T19:26:44Z","timestamp":1594668404000},"page":"1948-1958","source":"Crossref","is-referenced-by-count":307,"title":["COVID-19\u2013Associated Kidney Injury: A Case Series of Kidney Biopsy Findings"],"prefix":"10.1681","volume":"31","author":[{"given":"Purva","family":"Sharma","sequence":"first","affiliation":[{"name":"Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Great Neck, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nupur N.","family":"Uppal","sequence":"additional","affiliation":[{"name":"Division of Kidney Diseases and Hypertension, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Great Neck, New 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