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Proteinuria in COVID-19: prevalence, characterization and prognostic role

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,...

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Published in:Journal of nephrology 2021-04, Vol.34 (2), p.355-364
Main Authors: Huart, Justine, Bouquegneau, Antoine, Lutteri, Laurence, Erpicum, Pauline, Grosch, Stéphanie, Résimont, Guillaume, Wiesen, Patricia, Bovy, Christophe, Krzesinski, Jean-Marie, Thys, Marie, Lambermont, Bernard, Misset, Benoît, Pottel, Hans, Mariat, Christophe, Cavalier, Etienne, Burtey, Stéphane, Jouret, François, Delanaye, Pierre
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container_title Journal of nephrology
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creator Huart, Justine
Bouquegneau, Antoine
Lutteri, Laurence
Erpicum, Pauline
Grosch, Stéphanie
Résimont, Guillaume
Wiesen, Patricia
Bovy, Christophe
Krzesinski, Jean-Marie
Thys, Marie
Lambermont, Bernard
Misset, Benoît
Pottel, Hans
Mariat, Christophe
Cavalier, Etienne
Burtey, Stéphane
Jouret, François
Delanaye, Pierre
description 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 α 1 -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 (
doi_str_mv 10.1007/s40620-020-00931-w
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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 α 1 -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 (&lt; 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 α 1 -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 α 1 -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 α 1 -microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.</description><identifier>ISSN: 1121-8428</identifier><identifier>ISSN: 1724-6059</identifier><identifier>EISSN: 1724-6059</identifier><identifier>DOI: 10.1007/s40620-020-00931-w</identifier><identifier>PMID: 33484426</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject><![CDATA[Aged ; Aged, 80 and over ; alpha1-microglobulin ; Anesthesia & intensive care ; Anesthésie & soins intensifs ; Belgium - epidemiology ; Biomarkers - urine ; Business & economic sciences ; COVID-19 ; COVID-19 - complications ; COVID-19 - epidemiology ; COVID-19 - urine ; Female ; Gestion des systèmes d’information ; Human health and pathology ; Human health sciences ; Humans ; Laboratory medicine & medical technology ; Life Sciences ; Male ; Management information systems ; Medicine ; Medicine & Public Health ; Middle Aged ; Médecine de laboratoire & technologie médicale ; Nephrology ; Original ; Original Article ; Prevalence ; Prognosis ; Proteinuria ; Proteinuria - epidemiology ; Proteinuria - etiology ; Proteinuria - urine ; Public health, health care sciences & services ; Retrospective Studies ; Santé publique, services médicaux & soins de santé ; Sciences de la santé humaine ; Sciences économiques & de gestion ; Survival Rate - trends ; Tutubar protéinuria ; Urologie & néphrologie ; Urology ; Urology & nephrology ; Urology and Nephrology]]></subject><ispartof>Journal of nephrology, 2021-04, Vol.34 (2), p.355-364</ispartof><rights>The Author(s) 2021</rights><rights>Attribution</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c590t-66677376ee9dedc13824b354fccaa2f910f38ff69b733800f8896c383db1fd973</citedby><cites>FETCH-LOGICAL-c590t-66677376ee9dedc13824b354fccaa2f910f38ff69b733800f8896c383db1fd973</cites><orcidid>0000-0002-1480-5761 ; 0000-0003-2547-6593 ; 0000-0003-0074-8919 ; 0000-0002-7077-6731 ; 0000-0003-1813-7884</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,778,782,883,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33484426$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.inrae.fr/hal-03329771$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Huart, Justine</creatorcontrib><creatorcontrib>Bouquegneau, Antoine</creatorcontrib><creatorcontrib>Lutteri, Laurence</creatorcontrib><creatorcontrib>Erpicum, Pauline</creatorcontrib><creatorcontrib>Grosch, Stéphanie</creatorcontrib><creatorcontrib>Résimont, Guillaume</creatorcontrib><creatorcontrib>Wiesen, Patricia</creatorcontrib><creatorcontrib>Bovy, Christophe</creatorcontrib><creatorcontrib>Krzesinski, Jean-Marie</creatorcontrib><creatorcontrib>Thys, Marie</creatorcontrib><creatorcontrib>Lambermont, Bernard</creatorcontrib><creatorcontrib>Misset, Benoît</creatorcontrib><creatorcontrib>Pottel, Hans</creatorcontrib><creatorcontrib>Mariat, Christophe</creatorcontrib><creatorcontrib>Cavalier, Etienne</creatorcontrib><creatorcontrib>Burtey, Stéphane</creatorcontrib><creatorcontrib>Jouret, François</creatorcontrib><creatorcontrib>Delanaye, Pierre</creatorcontrib><title>Proteinuria in COVID-19: prevalence, characterization and prognostic role</title><title>Journal of nephrology</title><addtitle>J Nephrol</addtitle><addtitle>J Nephrol</addtitle><description>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 α 1 -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 (&lt; 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 α 1 -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 α 1 -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 α 1 -microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>alpha1-microglobulin</subject><subject>Anesthesia &amp; intensive care</subject><subject>Anesthésie &amp; soins intensifs</subject><subject>Belgium - epidemiology</subject><subject>Biomarkers - urine</subject><subject>Business &amp; economic sciences</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - urine</subject><subject>Female</subject><subject>Gestion des systèmes d’information</subject><subject>Human health and pathology</subject><subject>Human health sciences</subject><subject>Humans</subject><subject>Laboratory medicine &amp; medical technology</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Management information systems</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Médecine de laboratoire &amp; technologie médicale</subject><subject>Nephrology</subject><subject>Original</subject><subject>Original Article</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Proteinuria</subject><subject>Proteinuria - epidemiology</subject><subject>Proteinuria - etiology</subject><subject>Proteinuria - urine</subject><subject>Public health, health care sciences &amp; services</subject><subject>Retrospective Studies</subject><subject>Santé publique, services médicaux &amp; soins de santé</subject><subject>Sciences de la santé humaine</subject><subject>Sciences économiques &amp; de gestion</subject><subject>Survival Rate - trends</subject><subject>Tutubar protéinuria</subject><subject>Urologie &amp; néphrologie</subject><subject>Urology</subject><subject>Urology &amp; nephrology</subject><subject>Urology and Nephrology</subject><issn>1121-8428</issn><issn>1724-6059</issn><issn>1724-6059</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kUtv1DAUhSMEoqXwB1igLEEi4Ff8YIFUDY-ONFJZANsrx3EyrjL2YCdTtb8epymldMHC8pXvOZ-vfYriJUbvMELifWKIE1SheSFFcXX5qDjGgrCKo1o9zjUmuJKMyKPiWUoXCJG6JuxpcUQpk4wRflysv8UwWuen6HTpfLk6_7n-VGH1odxHe9CD9ca-Lc1WR21GG921Hl3wpfZtFoTehzQ6U8Yw2OfFk04Pyb643U-KH18-f1-dVZvzr-vV6aYytUJjxTkXggpurWptazCVhDW0Zp0xWpNOYdRR2XVcNYJSiVAnpeKGSto2uGuVoCfFx4W7n5pdJlg_Rj3APrqdjlcQtIN_O95toQ8HEJJQLFgG0AUwONtbCLFxcCA3xpt6GnrQBhoLhHAJpM6D8Ox6s7i2Dy47O93AfIYoJUoIfMBZ-_p2xBh-TTaNsHPJ2GHQ3oYpAWESUSZqRrOULFITQ0rRdndsjGBOGZaUAc1rThkus-nV_S-4s_yJ9e8TU2753ka4CFP0OZb_YX8D4J6yLQ</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Huart, Justine</creator><creator>Bouquegneau, Antoine</creator><creator>Lutteri, Laurence</creator><creator>Erpicum, Pauline</creator><creator>Grosch, Stéphanie</creator><creator>Résimont, Guillaume</creator><creator>Wiesen, Patricia</creator><creator>Bovy, Christophe</creator><creator>Krzesinski, Jean-Marie</creator><creator>Thys, Marie</creator><creator>Lambermont, Bernard</creator><creator>Misset, Benoît</creator><creator>Pottel, Hans</creator><creator>Mariat, Christophe</creator><creator>Cavalier, Etienne</creator><creator>Burtey, Stéphane</creator><creator>Jouret, François</creator><creator>Delanaye, Pierre</creator><general>Springer International Publishing</general><general>Italian Society of Nephrology/Springer</general><general>Wichtig Publishing</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>Q33</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1480-5761</orcidid><orcidid>https://orcid.org/0000-0003-2547-6593</orcidid><orcidid>https://orcid.org/0000-0003-0074-8919</orcidid><orcidid>https://orcid.org/0000-0002-7077-6731</orcidid><orcidid>https://orcid.org/0000-0003-1813-7884</orcidid></search><sort><creationdate>20210401</creationdate><title>Proteinuria in COVID-19: prevalence, characterization and prognostic role</title><author>Huart, Justine ; Bouquegneau, Antoine ; Lutteri, Laurence ; Erpicum, Pauline ; Grosch, Stéphanie ; Résimont, Guillaume ; Wiesen, Patricia ; Bovy, Christophe ; Krzesinski, Jean-Marie ; Thys, Marie ; Lambermont, Bernard ; Misset, Benoît ; Pottel, Hans ; Mariat, Christophe ; Cavalier, Etienne ; Burtey, Stéphane ; Jouret, François ; Delanaye, Pierre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c590t-66677376ee9dedc13824b354fccaa2f910f38ff69b733800f8896c383db1fd973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>alpha1-microglobulin</topic><topic>Anesthesia &amp; intensive care</topic><topic>Anesthésie &amp; soins intensifs</topic><topic>Belgium - epidemiology</topic><topic>Biomarkers - urine</topic><topic>Business &amp; economic sciences</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - urine</topic><topic>Female</topic><topic>Gestion des systèmes d’information</topic><topic>Human health and pathology</topic><topic>Human health sciences</topic><topic>Humans</topic><topic>Laboratory medicine &amp; 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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 α 1 -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 (&lt; 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 α 1 -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 α 1 -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 α 1 -microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33484426</pmid><doi>10.1007/s40620-020-00931-w</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-1480-5761</orcidid><orcidid>https://orcid.org/0000-0003-2547-6593</orcidid><orcidid>https://orcid.org/0000-0003-0074-8919</orcidid><orcidid>https://orcid.org/0000-0002-7077-6731</orcidid><orcidid>https://orcid.org/0000-0003-1813-7884</orcidid><oa>free_for_read</oa></addata></record>
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subjects Aged
Aged, 80 and over
alpha1-microglobulin
Anesthesia & intensive care
Anesthésie & soins intensifs
Belgium - epidemiology
Biomarkers - urine
Business & economic sciences
COVID-19
COVID-19 - complications
COVID-19 - epidemiology
COVID-19 - urine
Female
Gestion des systèmes d’information
Human health and pathology
Human health sciences
Humans
Laboratory medicine & medical technology
Life Sciences
Male
Management information systems
Medicine
Medicine & Public Health
Middle Aged
Médecine de laboratoire & technologie médicale
Nephrology
Original
Original Article
Prevalence
Prognosis
Proteinuria
Proteinuria - epidemiology
Proteinuria - etiology
Proteinuria - urine
Public health, health care sciences & services
Retrospective Studies
Santé publique, services médicaux & soins de santé
Sciences de la santé humaine
Sciences économiques & de gestion
Survival Rate - trends
Tutubar protéinuria
Urologie & néphrologie
Urology
Urology & nephrology
Urology and Nephrology
title Proteinuria in COVID-19: prevalence, characterization and prognostic role
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