Clinical and subclinical acute kidney injury in children with mild-to-moderate COVID-19

Saygılı, Seha; Canpolat, Nur; Çiçek, Rümeysa Yasemin; Ağbaş, Ayşe; Yılmaz, Esra Karabağ; Sakallı, Ayşe Ayzıt Kılınç; Aygün, Deniz; Akkoç, Gülşen; Demirbaş, Kaan Can; Konukoğlu, Díldar; Çokuğraş, Haluk; Çalışkan, Salim; Sever, Lale

doi:10.1038/s41390-022-02124-6

Cited by 12 publications

(12 citation statements)

References 38 publications

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“…They commented that a late diagnosis, based on the KDIGO guidelines, could contribute to a poor prognosis in patients with COVID-19. Although the development of AKI is usually associated with severe COVID-19, it has been shown that subAKI develops in patients with mild to moderate COVID-19, including children [27,28]. These observations emphasize the importance of the timely identification of subAKI in patients with COVID-19.…”

Section: Covid-19 and Kidney Diseasementioning

confidence: 94%

“…Saygili et al [28] showed an association between the neutrophil count and the development of AKI, pointing out the role of inflammation in this process. This hypothesis is reinforced by the observation, in a comparative study, that the prevalence of AKI in patients with COVID-19 is similar to that in patients infected with seasonal influenza [45].…”

Section: Proximal Tubule Epithelial Cells Are a Target For The Develo...mentioning

confidence: 99%

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Subclinical Acute Kidney Injury in COVID-19: Possible Mechanisms and Future Perspectives

Silva-Aguiar

Teixeira

Peres

et al. 2022

IJMS

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Since the outbreak of COVID-19 disease, a bidirectional interaction between kidney disease and the progression of COVID-19 has been demonstrated. Kidney disease is an independent risk factor for mortality of patients with COVID-19 as well as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to the development of acute kidney injury (AKI) and chronic kidney disease (CKD) in patients with COVID-19. However, the detection of kidney damage in patients with COVID-19 may not occur until an advanced stage based on the current clinical blood and urinary examinations. Some studies have pointed out the development of subclinical acute kidney injury (subAKI) syndrome with COVID-19. This syndrome is characterized by significant tubule interstitial injury without changes in the estimated glomerular filtration rate. Despite the complexity of the mechanism(s) underlying the development of subAKI, the involvement of changes in the protein endocytosis machinery in proximal tubule (PT) epithelial cells (PTECs) has been proposed. This paper focuses on the data relating to subAKI and COVID-19 and the role of PTECs and their protein endocytosis machinery in its pathogenesis.

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Section: Covid-19 and Kidney Diseasementioning

confidence: 94%

Section: Proximal Tubule Epithelial Cells Are a Target For The Develo...mentioning

confidence: 99%

Subclinical Acute Kidney Injury in COVID-19: Possible Mechanisms and Future Perspectives

Silva-Aguiar

Teixeira

Peres

et al. 2022

IJMS

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“…Indeed, NGAL elevation is most likely related to the activation of the immune system [ 36 ] explaining that urinary biomarkers, including NGAL, are not independently associated with AKI [ 9–12 , 30 ]. In the same vein, there is an association between elevated NGAL and mortality in COVID-19 patients, confirming its link with inflammation and severity [ 9 , 10 ] and also the role of inflammation in the development of AKI [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 87%

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

Larcher,

Bargnoux,

Badiou

et al. 2023

Renal Failure

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Tubular injury is the main cause of acute kidney injury (AKI) in critically ill COVID-19 patients. Proximal tubular dysfunction (PTD) and changes in urinary biomarkers, such as NGAL, TIMP-2, and IGFBP7 product ([TIMP-2]•[IGFBP7]), could precede AKI. We conducted a prospective cohort study from 2020/03/09 to 2020/05/03, which consecutively included all COVID-19 patients who had at least one urinalysis, to assess the incidence of PTD and AKI, and the effectiveness of PTD, NGAL, and [TIMP-2]•[IGFBP7] in AKI and persistent AKI prediction using the area under the receiver operating characteristic curves (AUCs), Kaplan–Meier methodology (log-rank tests), and Cox models. Among the 60 patients admitted to the ICU with proven COVID-19 (median age: 63-year-old (interquartile range: IQR, 55–74), 45 males (75%), median simplified acute physiology score (SAPS) II: 34 (IQR, 22–47) and median BMI: 25.7 kg/m 2 (IQR, 23.3–30.8)) analyzed, PTD was diagnosed in 29 patients (48%), AKI in 33 (55%) and persistent AKI in 20 (33%). Urinary NGAL had the highest AUC for AKI prediction: 0.635 (95%CI: 0.491–0.779) and persistent AKI prediction: 0.681 (95%CI: 0.535–0.826), as compared to PTD and [TIMP-2]•[IGFBP7] (AUCs <0.6). AKI was independently associated with higher SAPSII (HR = 1.04, 95%CI: 1.01–1.06, p = 0.005) and BMI (HR = 1.07, 95%CI: 1.00–1.14, p = 0.04) and persistent AKI with higher SAPSII (HR = 1.03, 95%CI: 1.00–1.06, p = 0.048) and nephrotoxic drug use (HR = 3.88, 95%CI: 1.20–12.5, p = 0.02). In conclusion, in critically ill COVID-19 patients, the incidence of PTD and AKI was relatively high. NGAL was the best urinary biomarker for predicting AKI, but only clinical severity was independently associated with its occurrence.

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“…Saygili et al assessed uIL-18 in 71 COVID-19 children, of whom 12 had AKI. Compared to healthy control children, uIL-18 was significantly increased; however, only 4 of 12 AKI children had increased levels of uIL-18 [ 26 ]. The actions of angiotensin-converting enzyme 2 (ACE2) oppose those of the renin-angiotensin-aldosterone system.…”

Section: Discussionmentioning

confidence: 99%

Serum and Urinary Biomarkers in COVID-19 Patients with or without Baseline Chronic Kidney Disease

Filev

Lyubomirova

Hristova

et al. 2023

JPM

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In a prospective, observational, non-interventional, single-center study, we assessed various plasma and urinary biomarkers of kidney injury (neutrophil gelatinase-associated Lipocain [NGAL], kidney-injury molecule-1 [KIM-1], and interleukin-18 [IL-18]); inflammation (IL-6, C-reactive protein [CRP]); plus angiotensin converting enzyme 2 (ACE2) in 120 COVID-19 patients (of whom 70 had chronic kidney disease (CKD) at emergency-department (ED) admission). Our aim was to correlate the biomarkers with the outcomes (death, acute kidney injury [AKI]). All patients had received a chest-CT scan at admission to calculate the severity score (0–5). Biomarkers were also assessed in healthy volunteers and non-COVID-19-CKD patients. These biomarkers statistically differed across subgroups, i.e., they were significantly increased in COVID-19 patients, except for urinary (u)KIM1 and uIL-18. Amongst the biomarkers, only IL-6 was independently associated with mortality, along with AKI and not using remdesivir. Regarding the prediction of AKI, only IL-6 and uKIM1 were significantly elevated in patients presenting with AKI. However, AKI could not be predicted. Having high baseline IL-6 levels was associated with subsequent ventilation requirement and death. The mortality rate was almost 90% when the chest CT-scan severity score was 3 or 4 vs. 6.8% when the severity score was 0–2 (p < 0.0001).

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Clinical and subclinical acute kidney injury in children with mild-to-moderate COVID-19

Cited by 12 publications

References 38 publications

Subclinical Acute Kidney Injury in COVID-19: Possible Mechanisms and Future Perspectives

Subclinical Acute Kidney Injury in COVID-19: Possible Mechanisms and Future Perspectives

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

Serum and Urinary Biomarkers in COVID-19 Patients with or without Baseline Chronic Kidney Disease

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