In a new study, researchers found that hospitalized patients with COVID-19 may face an increased risk for kidney injury, a dreaded complication for those suffering from infection with COVID-19.
They found that more than a third patients with COVID-19 end up in need of dialysis and are also at a much higher risk of death.
The research was conducted by a team at the University of Michigan and elsewhere.
According to the team, 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 that contributes to kidney injury in thousands of patients.
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.
In the study, 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 the levels of healthy people.
The team says a suPAR level at the 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.
This will help hospitals by providing proper surveillance of patients at higher risk of a severe COVID-19 course.
Now that scientists know the epidemiological link of suPAR to COVID-19-associated acute kidney injury (AKI), they must study if suPAR is a cause of COVID-19 associated AKI.
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.
One author of the study is Jochen Reiser, MD, Ph.D.
The study is published in the Journal of the American Society of Nephrology.
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