Proteinuria in COVID-19: prevalence, characterization and prognostic role.

Proteinuria has been commonly reported in patients with COVID-19. However, only dipstick tests have been frequently used thus far. Here, the quantification and characterization of proteinuria were investigated and their association with mortality was assessed. This retrospective, observational, single center study included 153 patients, hospitalized with COVID-19 between March 28th and April 30th, 2020, in whom total proteinuria and urinary α1-microglobulin (a marker of tubular injury) were measured. Association with mortality was evaluated, with a follow-up until May 7th, 2020. According to the Kidney Disease Improving Global Outcomes staging, 14% (n = 21) of the patients had category 1 proteinuria (< 150 mg/g of urine creatinine), 42% (n = 64) had category 2 (between 150 and 500 mg/g) and 44% (n = 68) had category 3 proteinuria (over 500 mg/g). Urine α1-microglobulin concentration was higher than 15 mg/g in 89% of patients. After a median follow-up of 27 [14;30] days, the mortality rate reached 18%. Total proteinuria and urinary α1-microglobulin were associated with mortality in unadjusted and adjusted models. This association was stronger in subgroups of patients with normal renal function and without a urinary catheter. Proteinuria is frequent in patients with COVID-19. Its characterization suggests a tubular origin, with increased urinary α1-microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.

Citation

Justine Huart, Antoine Bouquegneau, Laurence Lutteri, Pauline Erpicum, Stéphanie Grosch, Guillaume Résimont, Patricia Wiesen, Christophe Bovy, Jean-Marie Krzesinski, Marie Thys, Bernard Lambermont, Benoît Misset, Hans Pottel, Christophe Mariat, Etienne Cavalier, Stéphane Burtey, François Jouret, Pierre Delanaye. Proteinuria in COVID-19: prevalence, characterization and prognostic role. Journal of nephrology. 2021 Apr;34(2):355-364

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PMID: 33484426

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