Urine sediment findings were milder in patients with COVID-19-associated renal injuries than in those with non-COVID-19-associated renal injuries

Yoshifumi Morita; Makoto Kurano; Daisuke Jubishi; Mahoko Ikeda; Koh Okamoto; Masami Tanaka; Sohei Harada; Shu Okugawa; Kyoji Moriya; Yutaka Yatomi

doi:10.1016/j.ijid.2022.02.024

Urine sediment findings were milder in patients with COVID-19-associated renal injuries than in those with non-COVID-19-associated renal injuries

Int J Infect Dis. 2022 Apr:117:302-311. doi: 10.1016/j.ijid.2022.02.024. Epub 2022 Feb 17.

Authors

Affiliations

¹ Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan.
² Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan; Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: kurano-tky@umin.ac.jp.
³ Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan.
⁴ Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan; Department of Infection Control and Prevention, The University of Tokyo, Japan.
⁵ Department of Infection Control and Prevention, The University of Tokyo, Japan.
⁶ Department of Clinical Laboratory, University of Tokyo Hospital, Tokyo, Japan; Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Abstract

Background: Acute renal injury is an important complication of coronavirus disease 2019 (COVID-19). Both COVID-19-specific mechanisms, such as damage to the renal parenchyma by direct infection, and non-specific mechanisms, such as the pre-renal injury factors, have been proposed to be involved in COVID-19-associated renal injuries. In this study, we aimed to elucidate the characteristics of COVID-19-associated renal injuries, focusing mainly on urine sediment findings.

Methods: We compared the urine sediment findings and their associations with renal functions or urinary clinical parameters between subjects with COVID-19 and subjects without COVID-19 with acute renal injuries.

Results: We found that the number of urine sediment particles and the levels of N-acetyl-β-D-glucosaminidase, α1-microglobulin, liver type fatty acid-binding protein, and neutrophil gelatinase-associated lipocalin were associated with the severity of COVID-19. In addition, we observed that the number of granular casts, epithelial casts, waxy casts, and urinary chemical marker levels were lower in the subjects with COVID-19 than subjects without COVID-19 with acute renal injuries when the subjects were classified according to their renal function.

Conclusions: These results suggest that pre-renal injury factors might be largely involved in the pathogenesis of COVID-19-associated renal injuries compared with non-COVID-19-associated renal injuries arising from surgery or sepsis.

Keywords: Acute kidney injuries; COVID-19; Urine sediment findings.

MeSH terms

Acute Kidney Injury* / etiology
Acute Kidney Injury* / metabolism
Biomarkers / urine
COVID-19* / complications
Humans
Kidney / metabolism
Urinalysis / adverse effects

Substances

Biomarkers