Abstract: FR-PO1131
Proteinuria and Clinical Outcomes in Hospitalized COVID-19 Patients: Bolivia Experience
Session Information
- COVID-19 - II
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Claure-Del Granado, Rolando, Division of Nephrology Hospital Obrero No 2 - CNS, Cochabamba, Bolivia, Plurinational State of
- Garcia-Aguayo, Alem J., Division of Nephrology Hospital Obrero No 2 - CNS, Cochabamba, Bolivia, Plurinational State of
- Yang, Jason W., University of California San Diego School of Medicine, La Jolla, California, United States
- Zhang, Jingyao, University of California San Diego School of Medicine, La Jolla, California, United States
- Lee, Pei Lun, University of California San Diego School of Medicine, La Jolla, California, United States
- Malhotra, Rakesh, University of California San Diego School of Medicine, La Jolla, California, United States
Background
Kidney involvement is frequent among patients with coronavirus disease 2019 (COVID-19), and occurrence of AKI is associated with higher mortality in this population. The objective of this study was to describe incidence of proteinuria and its influence on AKI in COVID-19 patients.
Methods
We conducted a single-center prospective study among patients who were admitted with COVID-19 in a tertiary care center in Bolivia. Urine dipstick was performed, and spot urine protein/creatinine ratio was quantified within 24 hours of admission. AKI at hospital admission was excluded from analysis. Subsequent development of AKI was diagnosed using KDIGO criteria over 7 days follow-up. Secondary outcome was initiation of renal replacement therapy and death.
Results
Among 57 patients, de novo proteinuria at admission was present in 44 patients (77.1%). Mean urine protein/creatinine ratio was 896±1420 mg/g; with 4 patients (9%) presenting nephrotic range proteinuria. Patients with de novo proteinuria had higher leukocyte count (6395±1580/mm3 vs. 5212±870/mm3; p = 0.0127). De novo proteinuria was not different in patients with diabetes, hypertension or CKD. Of patients with de novo proteinuria, 34% (15/44) patients developed subsequent AKI. Majority of AKI cases (80%) were mild (stage 1 KDIGO). Urine protein-creatinine ratio ≥150 mg/g was associated with AKI (odds ratio (OR), 17.4; 95% CI, 0.97 to 31; p = 0.05). None of patients required kidney replacement therapy. Total proteinuria was associated with mortality in unadjusted and adjusted models.
Conclusion
We observed higher prevalence of proteinuria among patients admitted for COVID-19. Patient will proteinuria also had a higher risk of developing AKI and a poor prognosis for survival. Future studies should focus on proteinuria for risk stratification and prognosis.