Proteinuria and Clinical Outcomes in Hospitalized COVID-19 Patients : A Retrospective Single-Center Study
Copyright © 2021 by the American Society of Nephrology..
BACKGROUND AND OBJECTIVES: Kidney involvement is frequent among patients with coronavirus disease 2019 (COVID-19), and occurrence of AKI is associated with higher mortality in this population. The objective of this study was to describe occurrence and significance of proteinuria in this setting.
DESIGN , SETTING, PARTICIPANTS MEASUREMENTS: We conducted a single-center retrospective study to describe the characteristic features of proteinuria measured within 48 hours following admission among patients with COVID-19 admitted in a tertiary care hospital in France, and to evaluate its association with initiation of dialysis, intensive care unit admission, and death.
RESULTS: Among 200 patients with available data, urine protein-creatinine ratio at admission was ≥1 g/g for 84 (42%), although kidney function was normal in most patients, with a median serum creatinine of 0.94 mg/dl (interquartile range, 0.75-1.21). Median urine albumin-creatinine ratio was 110 mg/g (interquartile range, 50-410), with a urine albumin-protein ratio <50% in 92% of patients. Urine retinol binding protein concentrations, available for 85 patients, were ≥0.03 mg/mmol in 62% of patients. Urine protein-creatinine ratio ≥1 g/g was associated with initiation of dialysis (odds ratio, 4.87; 95% confidence interval, 2.03 to 13.0; P <0.001), admission to the intensive care unit (odds ratio, 3.55; 95% confidence interval, 1.93 to 6.71; P <0.001), and death (odds ratio, 3.56; 95% confidence interval, 1.90 to 6.54; P <0.001).
CONCLUSIONS: Proteinuria is very frequent among patients admitted for COVID-19 and may precede AKI. Low levels of albuminuria suggest a predominant tubular origin, confirmed by the elevated levels of urine retinol binding protein. Urine protein-creatinine ratio ≥1 g/g at admission is strongly associated with poor kidney and patient outcome.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Clinical journal of the American Society of Nephrology : CJASN - 16(2021), 4 vom: 01. Apr., Seite 514-521 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Karras, Alexandre [VerfasserIn] |
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| Anmerkungen: |
Date Revised 24.04.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.2215/CJN.09130620 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM322191645 |
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| 100 | 1 | |a Karras, Alexandre |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Proteinuria and Clinical Outcomes in Hospitalized COVID-19 Patients |b A Retrospective Single-Center Study |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 24.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2021 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Kidney involvement is frequent among patients with coronavirus disease 2019 (COVID-19), and occurrence of AKI is associated with higher mortality in this population. The objective of this study was to describe occurrence and significance of proteinuria in this setting | ||
| 520 | |a DESIGN , SETTING, PARTICIPANTS MEASUREMENTS: We conducted a single-center retrospective study to describe the characteristic features of proteinuria measured within 48 hours following admission among patients with COVID-19 admitted in a tertiary care hospital in France, and to evaluate its association with initiation of dialysis, intensive care unit admission, and death | ||
| 520 | |a RESULTS: Among 200 patients with available data, urine protein-creatinine ratio at admission was ≥1 g/g for 84 (42%), although kidney function was normal in most patients, with a median serum creatinine of 0.94 mg/dl (interquartile range, 0.75-1.21). Median urine albumin-creatinine ratio was 110 mg/g (interquartile range, 50-410), with a urine albumin-protein ratio <50% in 92% of patients. Urine retinol binding protein concentrations, available for 85 patients, were ≥0.03 mg/mmol in 62% of patients. Urine protein-creatinine ratio ≥1 g/g was associated with initiation of dialysis (odds ratio, 4.87; 95% confidence interval, 2.03 to 13.0; P <0.001), admission to the intensive care unit (odds ratio, 3.55; 95% confidence interval, 1.93 to 6.71; P <0.001), and death (odds ratio, 3.56; 95% confidence interval, 1.90 to 6.54; P <0.001) | ||
| 520 | |a CONCLUSIONS: Proteinuria is very frequent among patients admitted for COVID-19 and may precede AKI. Low levels of albuminuria suggest a predominant tubular origin, confirmed by the elevated levels of urine retinol binding protein. Urine protein-creatinine ratio ≥1 g/g at admission is strongly associated with poor kidney and patient outcome | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Livrozet, Marine |e verfasserin |4 aut | |
| 700 | 1 | |a Lazareth, Hélène |e verfasserin |4 aut | |
| 700 | 1 | |a Benichou, Nicolas |e verfasserin |4 aut | |
| 700 | 1 | |a Hulot, Jean-Sébastien |e verfasserin |4 aut | |
| 700 | 1 | |a Fayol, Antoine |e verfasserin |4 aut | |
| 700 | 1 | |a Chauvet, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Jannot, Anne-Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Penet, Marie-Aude |e verfasserin |4 aut | |
| 700 | 1 | |a Diehl, Jean-Luc |e verfasserin |4 aut | |
| 700 | 1 | |a Godier, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Sanchez, Olivier |e verfasserin |4 aut | |
| 700 | 1 | |a Mirault, Tristan |e verfasserin |4 aut | |
| 700 | 1 | |a Thervet, Eric |e verfasserin |4 aut | |
| 700 | 1 | |a Pallet, Nicolas |e verfasserin |4 aut | |
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