Soluble Urokinase Receptor (SuPAR) in COVID-19-Related AKI
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Soluble Urokinase Receptor (SuPAR) in COVID-19-Related AKI. / Azam, Tariq U; Shadid, Husam R; Blakely, Pennelope; O'Hayer, Patrick; Berlin, Hanna; Pan, Michael; Zhao, Peiyao; Zhao, Lili; Pennathur, Subramaniam; Pop-Busui, Rodica; Altintas, Izzet; Tingleff, Jens; Stauning, Marius A; Andersen, Ove; Adami, Maria-Evangelia; Solomonidi, Nicky; Tsilika, Maria; Tober-Lau, Pinkus; Arnaoutoglou, Eleni; Keitel, Verena; Tacke, Frank; Chalkias, Athanasios; Loosen, Sven H; Giamarellos-Bourboulis, Evangelos J; Eugen-Olsen, Jesper; Reiser, Jochen; Hayek, Salim S; International Study of Inflammation in COVID-19.
I: Journal of the American Society of Nephrology, Bind 31, Nr. 11, 2020, s. 2725-2735.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Soluble Urokinase Receptor (SuPAR) in COVID-19-Related AKI
AU - Azam, Tariq U
AU - Shadid, Husam R
AU - Blakely, Pennelope
AU - O'Hayer, Patrick
AU - Berlin, Hanna
AU - Pan, Michael
AU - Zhao, Peiyao
AU - Zhao, Lili
AU - Pennathur, Subramaniam
AU - Pop-Busui, Rodica
AU - Altintas, Izzet
AU - Tingleff, Jens
AU - Stauning, Marius A
AU - Andersen, Ove
AU - Adami, Maria-Evangelia
AU - Solomonidi, Nicky
AU - Tsilika, Maria
AU - Tober-Lau, Pinkus
AU - Arnaoutoglou, Eleni
AU - Keitel, Verena
AU - Tacke, Frank
AU - Chalkias, Athanasios
AU - Loosen, Sven H
AU - Giamarellos-Bourboulis, Evangelos J
AU - Eugen-Olsen, Jesper
AU - Reiser, Jochen
AU - Hayek, Salim S
AU - International Study of Inflammation in COVID-19
N1 - Copyright © 2020 by the American Society of Nephrology.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: AKI commonly occurs in patients with coronavirus disease 2019 (COVID-19). Its pathogenesis is poorly understood. The urokinase receptor system is a key regulator of the intersection between inflammation, immunity, and coagulation, and soluble urokinase plasminogen activator receptor (suPAR) has been identified as an immunologic risk factor for AKI. Whether suPAR is associated with COVID-19-related AKI is unknown.METHODS: In a multinational observational study of adult patients hospitalized for COVID-19, we measured suPAR levels in plasma samples from 352 adult patients that had been collected within 48 hours of admission. We examined the association between suPAR levels and incident in-hospital AKI.RESULTS: Of the 352 patients (57.4% were male, 13.9% were black, and mean age was 61 years), 91 (25.9%) developed AKI during their hospitalization, of whom 25 (27.4%) required dialysis. The median suPAR level was 5.61 ng/ml. AKI incidence rose with increasing suPAR tertiles, from a 6.0% incidence in patients with suPAR <4.60 ng/ml (first tertile) to a 45.8% incidence of AKI in patients with suPAR levels >6.86 ng/ml (third tertile). None of the patients with suPAR <4.60 ng/ml required dialysis during their hospitalization. In multivariable analysis, the highest suPAR tertile was associated with a 9.15-fold increase in the odds of AKI (95% confidence interval [95% CI], 3.64 to 22.93) and a 22.86-fold increase in the odds of requiring dialysis (95% CI, 2.77 to 188.75). The association was independent of inflammatory markers and persisted across subgroups.CONCLUSIONS: Admission suPAR levels in patients hospitalized for COVID-19 are predictive of in-hospital AKI and the need for dialysis. SuPAR may be a key component of the pathophysiology of AKI in COVID-19.
AB - BACKGROUND: AKI commonly occurs in patients with coronavirus disease 2019 (COVID-19). Its pathogenesis is poorly understood. The urokinase receptor system is a key regulator of the intersection between inflammation, immunity, and coagulation, and soluble urokinase plasminogen activator receptor (suPAR) has been identified as an immunologic risk factor for AKI. Whether suPAR is associated with COVID-19-related AKI is unknown.METHODS: In a multinational observational study of adult patients hospitalized for COVID-19, we measured suPAR levels in plasma samples from 352 adult patients that had been collected within 48 hours of admission. We examined the association between suPAR levels and incident in-hospital AKI.RESULTS: Of the 352 patients (57.4% were male, 13.9% were black, and mean age was 61 years), 91 (25.9%) developed AKI during their hospitalization, of whom 25 (27.4%) required dialysis. The median suPAR level was 5.61 ng/ml. AKI incidence rose with increasing suPAR tertiles, from a 6.0% incidence in patients with suPAR <4.60 ng/ml (first tertile) to a 45.8% incidence of AKI in patients with suPAR levels >6.86 ng/ml (third tertile). None of the patients with suPAR <4.60 ng/ml required dialysis during their hospitalization. In multivariable analysis, the highest suPAR tertile was associated with a 9.15-fold increase in the odds of AKI (95% confidence interval [95% CI], 3.64 to 22.93) and a 22.86-fold increase in the odds of requiring dialysis (95% CI, 2.77 to 188.75). The association was independent of inflammatory markers and persisted across subgroups.CONCLUSIONS: Admission suPAR levels in patients hospitalized for COVID-19 are predictive of in-hospital AKI and the need for dialysis. SuPAR may be a key component of the pathophysiology of AKI in COVID-19.
KW - Acute Kidney Injury/blood
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Betacoronavirus
KW - COVID-19
KW - Coronavirus Infections/complications
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Pandemics
KW - Pneumonia, Viral/complications
KW - Receptors, Urokinase Plasminogen Activator/blood
KW - SARS-CoV-2
U2 - 10.1681/ASN.2020060829
DO - 10.1681/ASN.2020060829
M3 - Journal article
C2 - 32963090
VL - 31
SP - 2725
EP - 2735
JO - Journal of the American Society of Nephrology : JASN
JF - Journal of the American Society of Nephrology : JASN
SN - 1046-6673
IS - 11
ER -
ID: 256219718