COVID-19-Associated Nephropathy: A Rare Case of Gross Hematuria and Acute Renal Failure

Strategic Insights -

A study published in the Journal of Clinical Medicine has reported a rare case of COVID-19 infection causing gross hematuria and severe acute renal failure in a patient with no respiratory symptoms. The case was diagnosed through kidney biopsy, which showed extensive c3 deposits, tubuloreticular inclusion bodies, and crescentic lesions. The patient responded well to treatment with steroids and antiviral medication (Remdesivir).

Key Takeaways:

  • The COVID-19 pandemic has presented a serious challenge to nephrologists, with many patients requiring renal replacement therapy due to severe kidney injury.
  • COVID-19 infection can lead to various glomerular injuries, including collapsing glomerulopathy, thrombotic microangiopathy-related renal failure, and pauci-immune glomerulonephritis.
  • The patient in this case report had a rare manifestation of COVID-19 infection, which was diagnosed through kidney biopsy and treated with steroids and antiviral medication.
  • The patient responded well to treatment and did not experience any further complications.
  • Crescentic glomerulonephritis is a possible etiology for severe acute kidney injury with hematuria in patients with active COVID-19 infection without respiratory symptoms.

Statistics:

  • The patient in this case report was a 45-year-old male with no underlying medical conditions.
  • He tested positive for SARS-CoV-2 but did not have any clinical respiratory symptoms.
  • The patient was treated with a steroid taper and antiviral medication (Remdesivir) and responded well to treatment.
  • The study highlights the importance of kidney biopsy in diagnosing COVID-19-associated nephropathy.
  • The patient's kidney function improved significantly after treatment.

Sources:

  • NewsRx. Data on COVID-19 Detailed by Researchers at Allina Health (Crescentic Glomerulonephritis Possibly Caused By Covid-19 Infection). Drug Week. June 27, 2025; p 32.
  • Journal of Clinical Medicine. Crescentic Glomerulonephritis Possibly Caused By Covid-19 Infection. 2025;14(10):3302.