Acute kidney injury in a Nigerian patient with COVID-19 and a shrunken kidney

Abstract

A case report of a 42 year old Nigerian male who presented with complaints of high grade intermittent fever, dry unproductive cough and difficulty in breathing of 3 days duration; with associated history of protracted vomiting and generalized body weakness. There was no history of recent travels and he was not aware of exposure to COVID-19 virus. A reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-COV2 was positive and he was treated for COVID-19 pneumonia. During the course of the illness, he had AKI with azotaemia, hyponatremia, hyperkalemia, acidosis, and anuria and had several sessions of haemodialysis among several medications. Renal ultrasound scan showed a shrunken right kidney and normal sized left kidney.On admission he developed deep vein thrombosis and was commenced on treatment. Renal function returned to near normal and he is being followed up in clinic.

The case report highlights the multifactorial risk factors of AKI in the setting of COVID-19 and the challenges of care in a low-resource setting.