Latin American registry of renal involvement in COVID-19 disease. The relevance of assessing proteinuria throughout the clinical course
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Fecha
2022
Autores
Lombardi, Raúl
Ferreiro, Alejandro
Ponce, Daniela
Claure-Del Granado, Rolando
Aroca, Gustavo
Venegas, Yanissa
Pereira, Mariana
Chavez-Iñiguez, Jonathan
Rojas, Nelson
Villa, Ana
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Public Library of Science
Resumen
The Latin American Society of Nephrology and Hypertension conducted a prospective
cohort, multinational registry of Latin American patients with kidney impairment associated
to COVID-19 infection with the objective to describe the characteristics of acute kidney disease
under these circumstances. The study was carried out through open invitation in order
to describe the characteristics of the disease in the region. Eight-hundred and seventy
patients from 12 countries were included. Median age was 63 years (54–74), most of
patients were male (68.4%) and with diverse comorbidities (87.2%). Acute kidney injury (AKI) was hospital-acquired in 64.7% and non-oliguric in 59.9%. Multiorgan dysfunction syndrome
(MODS) due to COVID-19 and volume depletion were the main factors contributing
to AKI (59.2% and 35.7% respectively). Kidney replacement therapy was started in 46.2%.
Non-recovery of renal function was observed in 65.3%. 71.5% of patients were admitted to
ICU and 72.2% underwent mechanical ventilation. Proteinuria at admission was present in
62.4% of patients and proteinuria during hospital-stay occurred in 37.5%. Those patients
with proteinuria at admission had higher burden of comorbidities, higher baseline sCr, and
MODS was severe. On the other hand, patients with de novo proteinuria had lower incidence
of comorbidities and near normal sCr at admission, but showed adverse course of
disease. COVID-19 MODS was the main cause of AKI in both groups. All-cause mortality of
the general population was 57.4%, and it was associated to age, sepsis as cause of AKI,
severity of condition at admission, oliguria, mechanical ventilation, non-recovery of renal
function, in-hospital complications and hospital stay. In conclusion, our study contributes to
a better knowledge of this condition and highlights the relevance of the detection of proteinuria
throughout the clinical course.
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Palabras clave
Nephrology, Hypertension, COVID-19, Multiorgan dysfunction syndrome
Citación
Lombardi R, Ferreiro A, Ponce D, Claure- Del Granado R, Aroca G, Venegas Y, et al. (2022) Latin American registry of renal involvement in COVID-19 disease. The relevance of assessing proteinuria throughout the clinical course. PLoS ONE 17(1): e0261764. https://doi.org/10.1371/ journal.pone.0261764