Early predictors of acute kidney injury in COVID‐19 patients

Abstract

Aim This study aims to determine the frequency of COVID‐19 related AKI and to identify the early predictors of AKI. Methods This study is a single‐center, retrospective, observational study. Hospitalized COVID‐19 patients between 24/03/2020 and 31/05/2020 were included in the study. All patients were evaluated for renal dysfunctions with urine dipstick, protein/creatinine ratio, albumin/creatinine ratio in spot urine, serum cystatin C, serum creatinine level on hospital admission, and 28th day of hospital admission. To assess the utility of these parameters to predict AKI, a receiver‐operating characteristic curve was generated and the area under the curve (AUC) was calculated. Results 348 patients were included. The average incidence of AKI was 4.9% (n = 17). The incidence of AKI in mild, moderate and severe COVID‐19 cases was 1.3% (n = 4), 9.0% (n = 3) and 76.9% (n = 10), respectively. Proteinuria was detected in 7.8% (n = 27) of patients with a urine dipstick test. In spot urine analysis, proteinuria was found in 20.1% (n = 70) of patients. The frequency of persistent proteinuria was 5.2% (n = 18). The AUC alue of serum cystatin C, D‐dimer and albumin/creatinine ratio to predict COVID‐19 related AKI were 0.96 (0.90 to 1.0), 0.94 (0.89–0.98), and 0.95 (0.91–0.98). Conclusion In COVID‐19 patients with normal serum creatinine levels on hospital admission, albuminuria, serum cystatin C and D‐dimer levels may be an early predictor of COVID‐19 related AKI and these patients should be monitored closely for AKI. Since the sample size in the AKI group was small, our study results should be confirmed with larger cohort studies.

Kidney injury molecule-1: potential biomarker of acute kidney injury and disease severity in patients with COVID-19

“…Proteinuria and albuminuria were also significantly elevated in COVID-19 patients with later occurrence of AKI, which concurs with the findings of previous studies [ 13 , 14 ]. However, compared to proteinuria and albuminuria, KIM-1 detected subsequent AKI with higher sensitivity and specificity.…”

Gender and Ethnic Disparities of Acute Kidney Injury in COVID-19 Infected Patients: A Literature Review

“…We identified the data by searching PubMed and references from relevant articles using the search terms “Coronavirus Disease 2019”, “COVID-19”, “SARS-CoV-2”, “kidney disease”, “acute kidney injury”, “AKI”, “risk factors”, “gender”, “clinical outcomes”, and “Clinical Characteristics”. We found that the SARS-CoV-2 infection rate in males is higher than that in females, and the incidence of AKI in males is also higher than that in females in most studies ( Figures 1 , 2 ) ( Cheng et al., 2020b ; Fisher et al., 2020 ; Hirsch et al., 2020 ; Kolhe et al., 2020 ; Pei et al., 2020 ; Sang et al., 2020 ; Zahid et al., 2020 ; Basalely et al., 2021 ; Chan et al., 2021 ; Cheng et al., 2021 ; Costa et al., 2021 ; Dai et al., 2021 ; Diebold et al., 2021 ; Gasparini et al., 2021 ; Martinez-Rueda et al., 2021 ; Mousavi Movahed et al., 2021 ; Ng et al., 2021 ; Ozturk et al., 2021 ; Russo et al., 2021 ; Xu H. et al., 2021 ; Xu J. et al., 2021 ; Yildirim et al., 2021 ; Zamoner et al., 2021 ). In these studies, all of the patients with COVID-19 had new-onset AKI during hospitalization.…”

Cystatin C: A Potential Predictor for Acute Kidney Injury in Patients With Community Acquired Pneumonia

“…Recently, Cigdem et al found that serum Cystatin C showed a good predictive power for AKI in patients with COVID-19. The AUC value of serum Cystatin C to predict COVID-19 related AKI was 0.96 (0.90 to 1.0), with the best cut-off value of 1.00 mg/L [22]. Albina et al previously investigated the potential of plasma N-terminal prohormone B-type natriuretic peptide (NT-proBNP), mid-regional pro-atrial natriuretic peptide (MR-proANP) and B-type natriuretic peptide (BNP) levels to predict early AKI in hospitalized patients with CAP.…”