Health
Investigators identify COVID-19, a major component of the kidney injury link
While Acute kidney injury (AKI) Coronavirus disease 2019 (COVID-19), its etiology is not well understood.
A team led by Tariq U. Azam, Department of Cardiology, University of Michigan, has begun to shed light on the etiology between AKI and COVID-19.
The urokinase receptor system may be an important regulator of the crossover between inflammation, immunity, and coagulation, while soluble urokinase plus minogen-activated receptor (suPAR) is immunological for acute kidney injury. It has been identified as a risk factor. However, researchers do not know if suPAR is linked to COVID-19-related AKI.
In a multinational observational study, researchers examined admitted adult COVID-19 patients. Researchers measured suPAR levels in plasma samples within 48 hours of admission of 352 patients and investigated the association between suPAR levels and in-hospital acute kidney injury.
The average age of the patient population was 61 years.
A total of 91 (25.9%) developed AKI during hospitalization, of which 25 (27.4%) required dialysis. The median suPAR level was 5.61 ng / ml, but with suPAR tertiles the AKI incidence was suPAR. <4.60 ng / ml（最初の三分位）の患者の6.0％発生率からsuPARレベルの患者のAKIの45.8％発生率まで増加しました> 6.86 ng / ml (third third quantile).
However, patients with suPAR <4.60 ng / ml during hospitalization did not require dialysis. In a multivariate analysis, the highest suPAR tertile increased the odds of acute kidney injury by 9.15 times (95% CI, 3.64 to 22.93) and 22.86 times the odds requiring dialysis (95% CI, 2.77 to 188.75). ). Researchers also found that this association was independent of inflammatory markers and persisted between different subgroups.
“Inpatient suPAR levels in patients admitted with COVID-19 predict the need for in-hospital AKI and dialysis,” the authors write. “SuPAR may be an important component of AKI’s pathophysiology in COVID-19.”
In another observational study of 3235 COVID-19 inpatients across the Mount Sinai Health System in New York, acute kidney injury occurred in 1406 patients (46%), of whom 280 (20%). I needed dialysis. Researchers have found that about 66% of these injuries are moderate to severe and that the majority of patients have evidence of proteinuria.
Other large studies conducted in both New York and China have yielded similar results for COVID-19 and acute kidney injury.
Earlier this year, researchers found a mathematical way to predict whether a patient was at high risk of developing the disease. Acute kidney injury.
In a diagnostic study, investigators investigated 495,971 adult hospital admissions between three university hospitals in Illinois. Researchers have data from Loyola University Medical Center (LUMC) in 2007-2017 (n = 200,613), the University of Chicago (UC) in 2008-2016 (n = 48,463), and North Shore serum creatinine (SCr) measurement patients. Used 2006-2016 University Health System (NUS) (n = 246,895).
Time-to-event analysis predicts the onset of a 27-hour median AKI a (IQR) with a probability cutoff of at least 0.057 before the University of Chicago cohort’s SCr concentration finally doubles. I understand. 34.5 hours in the NUS cohort and 39 hours in the LUMC cohort.
the study, “COVID-19-related AKI soluble urokinase receptor (SuPAR)“Is Journal of the American Society of Nephrology..
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