CASE REPORT article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1484385
Thrombotic microangiopathy with irreversible renal function in a CKD patient following COVID-19: case report
Provisionally accepted
- 1The Forth Hospital of Hebei Medical university, Shijiazhuang, China
- 2Bethune interentional Peace Hospital, Shijiazhuang, China
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We report a case of chronic kidney disease (CKD), in a patient with normal renal function, diagnosed as acute renal failure stage 3 after coronavirus disease 2019 (COVID-19)-associated thrombotic microangiopathy (TMA) characterized by the presence of thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure. The results of the renal biopsy were thickening of the small artery wall with mucous edema, endothelial swelling and hyperplasia, and segmental endothelial onion-like hyperplasia. However, the pathogenesis factors of the patient who suffered from COVID-19-associated TMA were not clear, although blood complements, activity of ADAMTS13, and Factor H were detected as normal. After the administration of pulse glucocorticoid, plasma exchange, and hemodialysis, the patient developed chronic renal failure and depended on peritoneal dialysis 12 months later. Although the clinical manifestations of TMA are similar, the etiology and pathogenesis are very complex. It is very important to determine the pathogenesis of TMA to proceed with precise treatment to improve the prognosis of the patient.
Keywords: COVID-19, thrombotic microangiopathy, Acute Kidney Injury, Chronic Kidney Disease, CRRT
Received: 17 Sep 2024; Accepted: 02 Sep 2025.
Copyright: © 2025 Li, Qin, Zhao, Yang, Bai and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yunlong Qin, Bethune interentional Peace Hospital, Shijiazhuang, China
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