Latin American registry of renal involvement in COVID-19 disease. The relevance of assessing proteinuria throughout the clinical course

Abstract

The Latin American Society of Nephrology and Hypertension conducted a prospective cohort, multinational registry of Latin American patients with kidney impairment associated to COVID-19 infection with the objective to describe the characteristics of acute kidney disease under these circumstances. The study was carried out through open invitation in order to describe the characteristics of the disease in the region. Eight-hundred and seventy patients from 12 countries were included. Median age was 63 years (54–74), most of patients were male (68.4%) and with diverse comorbidities (87.2%). Acute kidney injury (AKI) was hospital-acquired in 64.7% and non-oliguric in 59.9%. Multiorgan dysfunction syndrome (MODS) due to COVID-19 and volume depletion were the main factors contributing to AKI (59.2% and 35.7% respectively). Kidney replacement therapy was started in 46.2%. Non-recovery of renal function was observed in 65.3%. 71.5% of patients were admitted to ICU and 72.2% underwent mechanical ventilation. Proteinuria at admission was present in 62.4% of patients and proteinuria during hospital-stay occurred in 37.5%. Those patients with proteinuria at admission had higher burden of comorbidities, higher baseline sCr, and MODS was severe. On the other hand, patients with de novo proteinuria had lower incidence of comorbidities and near normal sCr at admission, but showed adverse course of disease. COVID-19 MODS was the main cause of AKI in both groups. All-cause mortality of the general population was 57.4%, and it was associated to age, sepsis as cause of AKI, severity of condition at admission, oliguria, mechanical ventilation, non-recovery of renal function, in-hospital complications and hospital stay. In conclusion, our study contributes to a better knowledge of this condition and highlights the relevance of the detection of proteinuria throughout the clinical course.

Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2

“…The present study concurs with the Latin American registry [ 35 ] which describes a high frequency of AKI (65%). In Mexico, incidences of 33.7 and 58.6% are reported, where half correspond to severe cases, with comorbidities consistent with the present study, where we documented that 30% of patients were overweight or had some degree of obesity.…”

Global Perspectives in Acute Kidney Injury: Bolivia

“…We have better understanding of COVID-19–related AKI in Bolivia because some centers from the three main cities in the country (La Paz, Santa Cruz, and Cochabamba) have participated in the recently published Latin American Society of Nephrology and Hypertension (SLANH) AKI committee epidemiology study. 6 Data from this study show that the incidence of COVID-19–related AKI was 31.6%, HA-AKI was 64.7%, and 46.2% required KRT. Nonrecovery of kidney function was observed in 65.3% of cases, with a mortality rate of 57.4%.…”

The Investigation of Kidney Involvement in 430 Hospitalized Patients with Omicron COVID-19 in Tianjin, China

“…A prospective cohort study showed that 62.4% of COVID-19 patients had proteinuria upon admission and 37.5% developed proteinuria during hospitalization. The overall prognosis is poor in patients with newly developed proteinuria [28]. Even in patients with mild symptoms, there is an increased risk of long-term renal damage [29].…”