Justine Huart1,2, Antoine Bouquegneau1, Laurence Lutteri3, Pauline Erpicum1,2, Stéphanie Grosch1, Guillaume Résimont1, Patricia Wiesen4, Christophe Bovy1, Jean-Marie Krzesinski1,2, Marie Thys5, Bernard Lambermont4, Benoît Misset4, Hans Pottel6, Christophe Mariat7, Etienne Cavalier3, Stéphane Burtey8,9, François Jouret1,2, Pierre Delanaye10,11. 1. Department of Nephrology-Dialysis-Transplantation, Service de Dialyse, CHU Sart Tilman, University of Liège (CHU ULiege), 4000, Liège, Belgium. 2. Groupe Interdisciplinaire de Géno-protéomique Appliquée, Cardiovascular Sciences, University of Liège, Liège, Belgium. 3. Department of Clinical Chemistry, CHU Sart Tilman, University of Liège (CHU ULiege), Liège, Belgium. 4. Department of Intensive Care, CHU Sart Tilman, University of Liège (CHU ULiege), Liège, Belgium. 5. Department of Medico-Economic Information, CHU Sart Tilman, University of Liège (CHU ULiege), Liège, Belgium. 6. Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium. 7. Nephrology, Dialysis and Renal Transplantation Department, Hôpital Nord, CHU de Saint-Etienne, Jean Monnet University, COMUE Université de Lyon, Lyon, France. 8. Center of Nephrology and Renal Transplantation, Public Assistance of the Hospitals of Marseille, Marseille, France. 9. Aix-Marseille University, INSERM, INRA, C2VN, Marseille, France. 10. Department of Nephrology-Dialysis-Transplantation, Service de Dialyse, CHU Sart Tilman, University of Liège (CHU ULiege), 4000, Liège, Belgium. pierre_delanaye@yahoo.fr. 11. Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nimes, France. pierre_delanaye@yahoo.fr.
Abstract
BACKGROUND: Proteinuria has been commonly reported in patients with COVID-19. However, only dipstick tests have been frequently used thus far. Here, the quantification and characterization of proteinuria were investigated and their association with mortality was assessed. METHODS: This retrospective, observational, single center study included 153 patients, hospitalized with COVID-19 between March 28th and April 30th, 2020, in whom total proteinuria and urinary α1-microglobulin (a marker of tubular injury) were measured. Association with mortality was evaluated, with a follow-up until May 7th, 2020. RESULTS: According to the Kidney Disease Improving Global Outcomes staging, 14% (n = 21) of the patients had category 1 proteinuria (< 150 mg/g of urine creatinine), 42% (n = 64) had category 2 (between 150 and 500 mg/g) and 44% (n = 68) had category 3 proteinuria (over 500 mg/g). Urine α1-microglobulin concentration was higher than 15 mg/g in 89% of patients. After a median follow-up of 27 [14;30] days, the mortality rate reached 18%. Total proteinuria and urinary α1-microglobulin were associated with mortality in unadjusted and adjusted models. This association was stronger in subgroups of patients with normal renal function and without a urinary catheter. CONCLUSIONS: Proteinuria is frequent in patients with COVID-19. Its characterization suggests a tubular origin, with increased urinary α1-microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.
BACKGROUND:Proteinuria has been commonly reported in patients with COVID-19. However, only dipstick tests have been frequently used thus far. Here, the quantification and characterization of proteinuria were investigated and their association with mortality was assessed. METHODS: This retrospective, observational, single center study included 153 patients, hospitalized with COVID-19 between March 28th and April 30th, 2020, in whom total proteinuria and urinary α1-microglobulin (a marker of tubular injury) were measured. Association with mortality was evaluated, with a follow-up until May 7th, 2020. RESULTS: According to the Kidney Disease Improving Global Outcomes staging, 14% (n = 21) of the patients had category 1 proteinuria (< 150 mg/g of urine creatinine), 42% (n = 64) had category 2 (between 150 and 500 mg/g) and 44% (n = 68) had category 3 proteinuria (over 500 mg/g). Urine α1-microglobulin concentration was higher than 15 mg/g in 89% of patients. After a median follow-up of 27 [14;30] days, the mortality rate reached 18%. Total proteinuria and urinary α1-microglobulin were associated with mortality in unadjusted and adjusted models. This association was stronger in subgroups of patients with normal renal function and without a urinary catheter. CONCLUSIONS:Proteinuria is frequent in patients with COVID-19. Its characterization suggests a tubular origin, with increased urinary α1-microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.
Authors: Leon Holzscheiter; Claus Beck; Sandra Rutz; Ekaterina Manuilova; Ingrid Domke; Walter G Guder; Walter Hofmann Journal: Clin Chem Lab Med Date: 2014-04 Impact factor: 3.694