Nav: Home

Patients with COVID-19 may have higher risk of kidney injury

September 22, 2020

Hospitalized patients with COVID-19 may face an increased risk for kidney injury, a dreaded complication for those suffering from infection with the novel 2019 coronavirus, an observational study led by University of Michigan researchers has found.

According to Jochen Reiser, MD, PhD, the Ralph C Brown MD professor and chairperson of Rush's Department of Internal Medicine, patients with COVID-19 experience elevated levels of soluble urokinase receptor (suPAR), an immune-derived pathogenic protein that is strongly predictive of kidney injury.

"SuPAR is a circulating factor we've seen contribute to kidney injury in thousands of patients," Reiser said. "RNA viruses such as HIV and SARS-CoV-2 (the virus that causes COVID-19) elicit a suPAR response of the innate immune system, leading to a rise in blood suPAR levels. If there is a hyperinflammatory suPAR response, kidney cells may be damaged."

Reiser is an author of the multicenter study led by Salim Hayek MD, an assistant professor of cardiology at University of Michigan, "Soluble Urokinase Receptor in COVID-19 related Acute Kidney Injury." Published online in the Journal of the American Society of Nephrology on Sept. 22, the study results show that more than a third patients with COVID-19 end up in need of dialysis and are also at much higher risk of death.

The research team tested suPAR levels of 352 study participants when they were admitted to the hospital for COVID-19 infection. A quarter of the participants developed acute kidney injury while hospitalized, and their median suPAR levels were more than 60% higher than those of the rest of the participants.

The risk of needing dialysis was increased 20-fold in patients with the highest suPAR levels. Overall, median suPAR levels for these study participants hospitalized with severe COVID-19 were almost three times higher than levels of healthy people.

"Certainly, a suPAR level at time of hospitalization of COVID-19 patients will provide an important risk stratification tool with respect to patient outcomes such as intubation or kidney failure," Hayek said. "This will help hospitals by providing proper surveillance of patients at higher risk of a severe COVID-19 course.

"Now that we know the epidemiological link of suPAR to COVID-19-associated acute kidney injury (AKI), we must study if suPAR is a cause of COVID-19 associated AKI," Reiser said. "In other words, can AKI in COVID-19 infected patients be prevented by keeping plasma suPAR levels low? This hypothesis is supported by the findings of the paper showing that COVID-19 infected study patients with a suPAR level below 4.6 ng/ml never needed dialysis. A newly developed and specific suPAR apheresis device is about to enter a clinical pilot trial where this scenario is tested."
-end-


Rush University Medical Center

Related Dialysis Articles:

Immediate dialysis no better than wait-until-necessary approach, researchers find
In the largest international study of its kind, researchers at the University of Alberta and Toronto's St.
Predictors of 5-year mortality in young dialysis patients
The analysis published in NDT [1] evaluated for the first time the association of a large number of demographic, HD treatment and laboratory variables with mortality in patients on chronic hemodialysis treatment since childhood.
COVID-19 mortality alarmingly high in dialysis patients
Analysis of a Spanish experience shows that COVID-19 is frequent in hemodialysis patients, who appear to be at risk for worse outcome.
Survival following switch from urgent in-center hemodialysis to home dialysis
Few patients who start urgent and unplanned dialysis in clinical centers switch to home dialysis.
Is ownership of dialysis facilities associated with access to kidney transplants?
An analysis that included data for nearly 1.5 million patients with end-stage kidney disease looked at whether ownership of dialysis facilities was associated with patients' access to kidney transplants.
At-home dialysis improves quality of life
The rate of people starting voluntary at-home peritoneal dialysis rose from 15% to 34% over 10 years at Kaiser Permanente in Northern California, providing a convenient and safe way to manage advanced-stage kidney disease compared with center-based hemodialysis, according to research published today in JAMA Internal Medicine.
Hydration sensor could improve dialysis
Researchers from MIT and Massachusetts General Hospital have now developed a portable sensor that can accurately measure patients' hydration levels using a technique known as nuclear magnetic resonance (NMR) relaxometry.
Uncovering possible role of polyphosphate in dialysis-related amyloidosis
Researchers from Osaka University found that the low concentrations of the naturally occurring biopolymer, polyphosphate (polyP), induces amyloid formation from β2 microglobulin under both acidic and neutral conditions but by different mechanisms.
Study compares dialysis reimbursement around the globe
Dialysis reimbursement policies in most countries are focused on conventional in-center hemodialysis, although home hemodialysis and peritoneal dialysis might contribute to quality of life and cost savings.
Elderly patients on dialysis have a high risk of dementia
Older kidney disease patients who are sick enough to require the blood-filtering treatment known as dialysis are at high risk of dementia, including Alzheimer's disease, according to a study led by scientists at Johns Hopkins Bloomberg School of Public Health.
More Dialysis News and Dialysis Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.