Analysis of early renal injury in COVID-19 and diagnostic value of multi-index combined detection

  1. Xu-wei Hong
  2. Ze-pai Chi
  3. Guo-yuan Liu
  4. Hong Huang
  5. Shun-qi Guo
  6. Jing-ru Fan
  7. Xian-wei Lin
  8. Liao-zhun Qu
  9. Rui-lie Chen
  10. Ling-jie Wu
  11. Liang-yu Wang
  12. Qi-chuan Zhang
  13. Su-wu Wu
  14. Ze-qun Pan
  15. Hao Lin
  16. Yu-hua Zhou
  17. Yong-hai Zhang
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Abstract

Objectives

The aim of the study was to analyze the incidence of COVID-19 with early renal injury, and to explore the value of multi-index combined detection in diagnosis of early renal injury in COVID-19.

Design

The study was an observational, descriptive study.

Setting

This study was carried out in a tertiary hospital in Guangdong, China.

Participants

12 patients diagnosed with COVID-19 from January 20, 2020 to February 20, 2020.

Primary and secondary outcome measures

The primary outcome was to evaluate the incidence of early renal injury in COVID-19. In this study, the estimated glomerular filtration rate (eGFR), endogenous creatinine clearance (Ccr) and urine microalbumin / urinary creatinine ratio (UACR) were calculated to assess the incidence of early renal injury. Secondary outcomes were the diagnostic value of urine microalbumin (UMA), α1-microglobulin (A1M), urine immunoglobulin-G (IGU), urine transferring (TRU) alone and in combination in diagnosis of COVID-19 with early renal injury.

Results

While all patients had no significant abnormalities in serum creatinine (Scr) and blood urea nitrogen (BUN), the abnormal rates of eGFR, Ccr, and UACR were 66.7%, 41.7%, and 41.7%, respectively. Urinary microprotein detection indicated that the area under curve (AUC) of multi-index combined to diagnose early renal injury in COVID-19 was 0.875, which was higher than UMA (0,813), A1M (0.813), IGU (0.750) and TRU (0.750) alone. Spearman analysis showed that the degree of early renal injury was significantly related to C-reactive protein (CRP) and neutrophil ratio (NER), suggesting that the more severe the infection, the more obvious the early renal injury. Hypokalemia and hyponatremia were common in patients with COVID-19, and there was a correlation with the degree of renal injury.

Conclusions

Early renal injury was common in patients with COVID-19. Combined detection of UMA, A1M, IGU, and TRU was helpful for the diagnosis of early renal injury in COVID-19.

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