Acute kidney injury in critical COVID-19 patients: usefulness of urinary biomarkers and kidney proximal tubulopathy

Larcher, Romaric; Bargnoux, Anne-Sophie; Badiou, Stephanie; Besnard, Noemie; Brunot, Vincent; Daubin, Delphine; Platon, Laura; Benomar, Racim; Amalric, Matthieu; Dupuy, Anne-Marie; Klouche, Kada; Cristol, Jean-Paul

doi:10.1080/0886022x.2023.2292152

Cited by 3 publications

(2 citation statements)

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“…Consistent with previous studies, patients with no AKI diagnosis had the highest transition rates to stage 1 AKI within the first week during the whole intensive care unit stay [ 39 ]. The incidence rate of AKI in patients with severe COVID-19 ranges from 41% to 62% [ 6 – 8 ], and most cases are classified as transient AKI that rapidly develops within the first week after SARS-CoV-2 infection [ 40 , 41 ]. Furthermore, we observed that mild COVID-19 infection had no significant influence on the risk of subsequent acute kidney disorder over the 4 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with COVID-19, kidney involvement is common. The incidence rate of acute kidney injury (AKI) can reach 41% to 62% [ 6 – 9 ] in patients with COVID-19. Despite the high incidence of AKI, research has revealed that the majority of patients can recover within the first week (the median number of days to recover from AKI is 6) following infection [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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The Time-Varying Impact of COVID-19 on the Acute Kidney Disorders: A Historical Matched Cohort Study and Mendelian Randomization Analysis

Li,

Zhang,

Chen

et al. 2024

Health Data Sci

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Background: This study aimed to explore the time-varying impact of COVID-19 on acute kidney disorders, including acute kidney injury and other acute kidney diseases. Methods: From the UK Biobank, 10,121 participants with COVID-19 were matched with up to 3 historically unexposed controls by age, sex, Townsend deprivation index, and the status of hospitalization or receiving critical care. We investigated the association between COVID-19 and incidence of acute kidney disorders, within the first 4 weeks after infection, using conditional and time-varying Cox proportional hazard regression. In addition, one-sample Mendelian randomization, utilizing the polygenic risk score for COVID-19 as an instrumental variable, was conducted to explore the potential causality of the association. Results: In the matched cohort study, we observed a significant association between COVID-19 and acute kidney disorders predominantly within the first 3 weeks. The impact of COVID-19 was time dependent, peaking in the second week (hazard ratio, 12.77; 95% confidence interval, 5.93 to 27.70) and decreasing by the fourth week (hazard ratio, 2.28; 95% confidence interval, 0.75 to 6.93). In subgroup analyses, only moderate to severe COVID-19 cases were associated with acute worsening of renal function in a time-dependent pattern. One-sample Mendelian randomization analyses further showed that COVID-19 might exert a “short-term” causal effect on the risk of acute kidney disorders, primarily confined to the first week after infection. Conclusions: The risk of acute kidney disorders following COVID-19 demonstrates a time-varying pattern. Hazard effects were observed only in patients with moderate or severe but not mild COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Time-Varying Impact of COVID-19 on the Acute Kidney Disorders: A Historical Matched Cohort Study and Mendelian Randomization Analysis

Li,

Zhang,

Chen

et al. 2024

Health Data Sci

View full text Add to dashboard Cite

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Kidney damage associated with COVID-19: from the acute to the chronic phase

Nlandu,

Tannor,

Bafemika

et al. 2024

Renal Failure

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Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) infection is well established as a systemic disease including kidney damage. The entry point into the renal cell remains the angiotensin-converting enzyme 2 (ACE-2) receptor and the spectrum of renal lesions is broad, with a clear predominance of structural and functional tubular lesions. The most common form of glomerular injury is collapsing glomerulopathy (CG), which is strongly associated with apolipoprotein L1(APOL-1) risk variants. These acute lesions, which are secondary to the direct or indirect effects of SARS-CoV-2, can progress to chronicity and are specific to long COVID-19 in the absence of any other cause. Residual inflammation associated with SARS-CoV-2 infection, in addition to acute kidney injury (AKI) as a transitional state with or without severe histological lesions, may be responsible for greater kidney function decline in mild-to-moderate COVID-19. This review discusses the evidence for renal histological markers of chronicity in COVID-19 patients and triggers of low-grade inflammation that may explain the decline in kidney function in the post-COVID-19 period.

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Urinary Neutrophil Gelatinase-Associated Lipocalin as a Predictor of COVID-19 Mortality in Hospitalized Patients

Švitek,

Zlosa,

Grubišić

et al. 2024

AMH

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Neutrophil gelatinase-associated lipocalin (NGAL) is a protein secreted by activated neutrophils and certain tissues. The aim of this study was to investigate the prognostic role of urinary neutrophil gelatinase-associated lipocalin (uNGAL) in hospitalized COVID-19 patients with regard to mortality. The prospective observational cohort study involved 86 hospitalized adult COVID-19 patients. Patients’ urine samples were collected upon admission and 48–72 h after admission. General anamnesis and clinical status information were obtained from medical records. Within 24 h of sample collection, urine aliquots were centrifuged, the supernatant was separated, and samples were frozen at −80 °C until uNGAL concentration measurement, which was performed within two years of sample collection. The patients were categorized into groups based on disease outcome (survived/deceased). Data analysis was performed to identify predictive factors and diagnostic indicators for the unfavorable outcome group using logistic regression and ROC curve methods. Logistic regression associated age, cardiomyopathy, invasive mechanical ventilation, and uNGAL concentration (follow-up sampling) with mortality. ROC analysis identified uNGAL concentration (follow-up sampling) as an indicator of mortality, with a cut-off value of >23.8 ng/mL. This study concludes that there is an association between disease outcome and uNGAL concentration in COVID-19 patients. However, understanding the dynamics of uNGAL concentration during COVID-19 remains limited, which is crucial for its effective clinical application.

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Acute kidney injury in critical COVID-19 patients: usefulness of urinary biomarkers and kidney proximal tubulopathy

Cited by 3 publications

References 44 publications

The Time-Varying Impact of COVID-19 on the Acute Kidney Disorders: A Historical Matched Cohort Study and Mendelian Randomization Analysis

The Time-Varying Impact of COVID-19 on the Acute Kidney Disorders: A Historical Matched Cohort Study and Mendelian Randomization Analysis

Kidney damage associated with COVID-19: from the acute to the chronic phase

Urinary Neutrophil Gelatinase-Associated Lipocalin as a Predictor of COVID-19 Mortality in Hospitalized Patients

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