An Update from UKRO on the Coronavirus
Dear Friends of UKRO,
We hope this finds you and your loved ones well and coping successfully with the coronavirus.
Everyone in the world is experiencing an especially difficult challenge in the form of this pandemic, but for those in the community of kidney patients, these are even more dangerous times. Most kidney patients have compromised immune systems which makes them especially vulnerable to the pernicious and rampaging nature of this virus. Kidney patients require regular and frequent blood and urine tests, monitoring, and medical appointments, and this is especially true regarding recipients of kidney transplants. Hemodialysis patients must go to clinics three or four times a week for three or four hours at a time to have their blood detoxified, putting them in the close company of other patients and numerous dialysis nurses, technicians, and related personnel. Other frequent tests require kidney patients to go to hospitals and clinics for imaging and radiology, thus making it difficult for them to stay safe.
The coronavirus has put a spotlight on vulnerable individuals, such as those suffering from other serious illnesses, the immune suppressed, the elderly, and has turned what used to be routine medical appointments into scary trips with the risk of exposure to people or environments carrying the virus. Social distancing becomes difficult or impossible in such circumstances. These problems impact family members of kidney patients and make much more difficult the already burdensome requirements of helping them with their needs.
Every night our television sets provide an all too sober picture of how unprepared our country and most others were and are to deal with a pandemic affecting large and heterogeneous populations and how limited our local, state, and federal resources are in countering this kind of medical emergency. For too long we have not invested in our public health infrastructure and its capabilities to deal with and defeat major pandemics.
Of late we have all been engulfed with grim statistics of the numbers of people infected with the virus and the tragic actual or anticipated death toll. In the kidney world we are all too familiar with other alarming statistics, such as the more than 470,000 Americans who depend annually on kidney dialysis to survive, and the approximately 95,000 Americans desperately awaiting a kidney transplant. These numbers have been with us for decades and, like the coronavirus, won’t go away until we find medical therapies or a vaccine or other cures through medical research.
The lesson in all of this is the paramount importance of medical research.
Research in these areas is expensive and time consuming, and as we have in the past, we must be persevering in pursuit of solutions to these devastating diseases. The eradication of these diseases must become national medical priorities. Our world, and especially the United States, are blessed with vast numbers of academic and commercial research institutes and laboratories which must be fully mobilized in the effort to unlock both the causes of the coronavirus and all forms of kidney disease. While kidney diseases fortunately do not represent the existential threat posed by the coronavirus, nevertheless the suffering and misery caused by kidney diseases most certainly is more than sufficient incentive to us to make every effort to place the fight against kidney disease high up on our list of key public health objectives.
We wish to thank all of you for your continued support for UKRO and your long commitment to battle kidney disease. We will continue to provide updates on our activities and achievements on our website, as well as informative articles and source materials concerning kidney health.
Human life has been threatened in the past by scourges such as small pox, tuberculosis, polio, malaria, HIV, measles, whooping cough, diphtheria, hepatitis A + B, and conventional influenzas, among others, and in due time medical science came to our rescue and we survived. We are optimistic that the same thing will happen regarding the coronavirus despite the horrendous worldwide impact it is having.
We urge all of you to be cautious and follow the directives of our medical professionals in dealing with your daily activities and responsibilities, and we look forward to the day when we can again greet you personally and thank you for your support for UKRO and kidney research at the Keck School of Medicine of USC.
For a more technical medical statement concerning the effect of the coronavirus on the kidneys, see the comments of Dr. Vito Campese below.
Stay safe and healthy,
Ken Kleinberg
UKRO PRESIDENT
Dr. Vito M. Campese
PROFESSOR EMERITUS OF MEDICINE, CO-DIRECTOR OF THE USC/UKRO KIDNEY RESEARCH CENTER, FORMER CHAIR OF THE DIVISION OF NEPHROLOGY AND HYPERTENSION, KECK SCHOOL OF MEDICINE OF USC, GRAND OFF. ORD. STAR OF ITALY
Novel Coronavirus disease (COVID-19) is a newly discovered contagious disease caused by severe acute respiratory syndrome (SARS)–coronavirus (CoV)-2 virus, primarily manifesting as an acute respiratory illness with interstitial and alveolar pneumonia, but it can affect multiple organs such as the kidney, heart, digestive tract, blood, and nervous system.
The kidney appears to be a common target of the virus. Blood urea nitrogen was elevated in 27% overall and in two-thirds of patients who died. Computed tomography scan of the kidneys showed reduced density, suggestive of inflammation and edema. Cheng et al. recently reported that amongst 710 consecutive hospitalized patients with COVID-19, 44% had proteinuria and hematuria and 26.7% had hematuria on admission. One case of FSGS allegedly caused by coronavirus has been reported in the literature. The prevalence of elevated serum creatinine and blood urea nitrogen was 15.5% and 14.1%, respectively. Acute kidney injury was an independent risk factor for patients’ in-hospital mortality.
Continuous renal replacement therapy (CRRT) has been used as treatment of choice in these patients with the scope of improving uremic symptoms, removing fluids and, more importantly, removing cytokines. In one study, high-volume hemofiltration in a dose of 6 l/h removed inflammatory cytokines (IL-6) and improved the Sequential Organ Failure Assessment scores at day 7 in patients with sepsis.
We hope this finds you and your loved ones well and coping successfully with the coronavirus.
Everyone in the world is experiencing an especially difficult challenge in the form of this pandemic, but for those in the community of kidney patients, these are even more dangerous times. Most kidney patients have compromised immune systems which makes them especially vulnerable to the pernicious and rampaging nature of this virus. Kidney patients require regular and frequent blood and urine tests, monitoring, and medical appointments, and this is especially true regarding recipients of kidney transplants. Hemodialysis patients must go to clinics three or four times a week for three or four hours at a time to have their blood detoxified, putting them in the close company of other patients and numerous dialysis nurses, technicians, and related personnel. Other frequent tests require kidney patients to go to hospitals and clinics for imaging and radiology, thus making it difficult for them to stay safe.
The coronavirus has put a spotlight on vulnerable individuals, such as those suffering from other serious illnesses, the immune suppressed, the elderly, and has turned what used to be routine medical appointments into scary trips with the risk of exposure to people or environments carrying the virus. Social distancing becomes difficult or impossible in such circumstances. These problems impact family members of kidney patients and make much more difficult the already burdensome requirements of helping them with their needs.
Every night our television sets provide an all too sober picture of how unprepared our country and most others were and are to deal with a pandemic affecting large and heterogeneous populations and how limited our local, state, and federal resources are in countering this kind of medical emergency. For too long we have not invested in our public health infrastructure and its capabilities to deal with and defeat major pandemics.
Of late we have all been engulfed with grim statistics of the numbers of people infected with the virus and the tragic actual or anticipated death toll. In the kidney world we are all too familiar with other alarming statistics, such as the more than 470,000 Americans who depend annually on kidney dialysis to survive, and the approximately 95,000 Americans desperately awaiting a kidney transplant. These numbers have been with us for decades and, like the coronavirus, won’t go away until we find medical therapies or a vaccine or other cures through medical research.
The lesson in all of this is the paramount importance of medical research.
Research in these areas is expensive and time consuming, and as we have in the past, we must be persevering in pursuit of solutions to these devastating diseases. The eradication of these diseases must become national medical priorities. Our world, and especially the United States, are blessed with vast numbers of academic and commercial research institutes and laboratories which must be fully mobilized in the effort to unlock both the causes of the coronavirus and all forms of kidney disease. While kidney diseases fortunately do not represent the existential threat posed by the coronavirus, nevertheless the suffering and misery caused by kidney diseases most certainly is more than sufficient incentive to us to make every effort to place the fight against kidney disease high up on our list of key public health objectives.
We wish to thank all of you for your continued support for UKRO and your long commitment to battle kidney disease. We will continue to provide updates on our activities and achievements on our website, as well as informative articles and source materials concerning kidney health.
Human life has been threatened in the past by scourges such as small pox, tuberculosis, polio, malaria, HIV, measles, whooping cough, diphtheria, hepatitis A + B, and conventional influenzas, among others, and in due time medical science came to our rescue and we survived. We are optimistic that the same thing will happen regarding the coronavirus despite the horrendous worldwide impact it is having.
We urge all of you to be cautious and follow the directives of our medical professionals in dealing with your daily activities and responsibilities, and we look forward to the day when we can again greet you personally and thank you for your support for UKRO and kidney research at the Keck School of Medicine of USC.
For a more technical medical statement concerning the effect of the coronavirus on the kidneys, see the comments of Dr. Vito Campese below.
Stay safe and healthy,
Ken Kleinberg
UKRO PRESIDENT
Dr. Vito M. Campese
PROFESSOR EMERITUS OF MEDICINE, CO-DIRECTOR OF THE USC/UKRO KIDNEY RESEARCH CENTER, FORMER CHAIR OF THE DIVISION OF NEPHROLOGY AND HYPERTENSION, KECK SCHOOL OF MEDICINE OF USC, GRAND OFF. ORD. STAR OF ITALY
Further Comments on Coronavirus and the Kidney
Novel Coronavirus disease (COVID-19) is a newly discovered contagious disease caused by severe acute respiratory syndrome (SARS)–coronavirus (CoV)-2 virus, primarily manifesting as an acute respiratory illness with interstitial and alveolar pneumonia, but it can affect multiple organs such as the kidney, heart, digestive tract, blood, and nervous system.
The kidney appears to be a common target of the virus. Blood urea nitrogen was elevated in 27% overall and in two-thirds of patients who died. Computed tomography scan of the kidneys showed reduced density, suggestive of inflammation and edema. Cheng et al. recently reported that amongst 710 consecutive hospitalized patients with COVID-19, 44% had proteinuria and hematuria and 26.7% had hematuria on admission. One case of FSGS allegedly caused by coronavirus has been reported in the literature. The prevalence of elevated serum creatinine and blood urea nitrogen was 15.5% and 14.1%, respectively. Acute kidney injury was an independent risk factor for patients’ in-hospital mortality.
Continuous renal replacement therapy (CRRT) has been used as treatment of choice in these patients with the scope of improving uremic symptoms, removing fluids and, more importantly, removing cytokines. In one study, high-volume hemofiltration in a dose of 6 l/h removed inflammatory cytokines (IL-6) and improved the Sequential Organ Failure Assessment scores at day 7 in patients with sepsis.
About UKRO and the USC/UKRO Kidney Research Center
UKRO is a Los Angeles-based nonprofit charity founded in 2002 by entertainment lawyer Kenneth Kleinberg with the help of Dr. Vito M. Campese, then Professor and Chief of the Division of Nephrology and Hypertension at the Keck School of Medicine of USC. Our mission is fundraising to support medical research and education related to the causes, treatment, and eradication of all forms of kidney disease.
Since 2002, UKRO has raised significant dollars to fund cutting-edge research at the earliest stage of development, in addition to educational symposia and fellowships. Our special project grants have been awarded to nationally recognized experts from interdisciplinary labs at the Keck School of Medicine of USC, City of Hope, and UCLA.
We believe that collaboration among scientists working in a variety of fields is the key to understanding chronic kidney disease, discovering improved therapies, and finding a much-needed cure. To that end, in September 2012, UKRO entered into an agreement with the Keck School of Medicine of the University of Southern California to establish what we envision as a premier center nationally for kidney research—the USC/UKRO Kidney Research Center (KRC). We have made an initial $3.5 million pledge to support the establishment of the KRC, which officially opened in 2015. UKRO’s gift will be matched by equivalent contributions from the Keck School of Medicine of USC. Led by Kenneth Hallows, M.D., Ph.D., F.A.S.N., the research team at the KRC is exploring kidney regeneration and stem cell therapies, acute kidney injury, hypertension, polycystic kidney disease, acid regulation, kidney cancer, and more.
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