Influenza A virus replication in primary human kidney cells reveals regulated cell death as a potential factor for acute kidney injury in influenza

Influenza A virus (IAV) infection can cause the lethal acute respiratory distress syndrome of the lung (ARDS). However, AKI is frequently noticed and correlated to an increased mortality. While the causality for influenza-related ARDS is well established, the pathogenesis of influenza-related AKI is incompletely understood. Yet, in post mortem studies of patients infected with H1N1- or H5N6-type IAV, viral antigen was detected in tubular and glomerular cells. Relevantly, receptors for human and avian IAV are present on human kidney cells, viremia was observed and IAV was repeatedly detected by infectivity- and PCR assays in human urine.