scholarly journals High SARS-CoV-2 Viral Load in Urine Sediment Correlates with Acute Kidney Injury and Poor COVID-19 Outcome

2021 ◽  
pp. ASN.2021010059
Author(s):  
Paulo Caceres ◽  
Gina Savickas ◽  
Shannon Murray ◽  
Kausik Umanath ◽  
Junior Uduman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Viral Load ◽  
Severe Acute Respiratory Syndrome ◽  
Medical Care ◽  
Kidney Injury ◽  
Viral Infectivity ◽  
Viral Detection ◽  
Urine Sediment ◽  
Viral Receptor ◽  
Qrt Pcr

BackgroundAcute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19) that is associated with high mortality. Despite documented kidney tropism of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there are no consistent reports of viral detection in urine or correlation with AKI or COVID-19 severity. Here we hypothesize that quantification of SARS-CoV-2 viral load in urine sediment from COVID-19 patients correlates with occurrence of AKI and mortality. MethodsSARS-CoV-2 viral load in urine sediments (U-viral load) was quantified by qRT-PCR in 52 patients with PCR-confirmed COVID-19 diagnosis, hospitalized between March 15th and June 8th, 2020. Immunolabeling of SARS-CoV-2 proteins Spike and Nucleocapsid was performed in two COVID-19 kidney biopsies and urine sediments. Viral infectivity assays were performed from 32 urine sediments. ResultsTwenty COVID-19 patients (39%) had detectable SARS-CoV-2 U-viral load, of which 17 (85%) developed AKI with an average U-viral load 4-times higher than non-AKI COVID-19 patients. U-viral load was highest (7.7-fold) within two weeks after AKI diagnosis. A higher U-viral load correlated with mortality but not with albuminuria or AKI stage. SARS-CoV-2 proteins partially colocalized with the viral receptor ACE2 in kidney biopsies in tubules and parietal cells, and in urine sediment cells. Infective SARS-CoV-2 was not detected in urine sediments. ConclusionOur results further support SARS-CoV-2 kidney tropism. A higher SARS-CoV-2 viral load in urine sediments from COVID-19 patients correlated with increased incidence of AKI and mortality. Urinary viral detection could inform medical care of COVID-19 patients with kidney injury to improve prognosis.

scholarly journals Cytomegalovirus in urinary sediment in patients with acute kidney injury

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sahra Pajenda ◽  
Sebastian Kapps ◽  
Daniela Gerges ◽  
Gregor Hoermann ◽  
Ludwig Wagner ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Allograft ◽  
Quantitative Polymerase Chain Reaction ◽  
Rna Extraction ◽  
Kidney Injury ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Urine Sediment ◽  
Urinary Sediment

Abstract Background Immunosuppression in solid organ transplantation is associated with frequent infections. Renal allograft recipients are susceptible to opportunistic infections and can acquire human cytomegalovirus (HCMV) infections even within the allograft. There, HCMV can be found in both the glomerulus and tubular cells, but is mostly restricted to specific and circumscribed sites. Therefore, not all organ infections are identifiable by immunohistology for HCMV proteins in fine needle core biopsies. Thus, we performed a urinalysis study to search for HCMV-specific RNA transcripts in the urine sediment of patients with acute kidney injury. Methods Urinary sediment of 90 patients with acute kidney injury (AKI), including 48 renal transplant recipients (RTX) and 42 non-transplant recipients (nRTX), was collected from morning urine for RNA extraction and reverse transcription. The copy number of HCMV transcripts was evaluated using a UL132 HCMV-specific probe set and by real-time quantitative polymerase chain reaction (RT-qPCR). Results Of the 48 RTX patients, ten showed HCMV copies in their urine sediment cells. Within this group, three recipients had negative HCMV serology and received an allograft from an HCMV-seropositive donor. In addition, all three RTX patients on a belatacept-based immunosuppressive regimen had HCMV transcripts in their urine. Of the 42 nRTX patients, only two had detectable HCMV transcripts in urine sediment cells and both were under immunosuppression. Conclusions Ten immunosuppressed renal allograft recipients and two immunosuppressed non-transplant patients with AKI showed HCMV copies in urine sediment. Thus, HCMV positivity in urinary sediment appears to be associated with immunosuppression. This study describes a novel noninvasive method for detection of HCMV in urinary sediment. Whether all HCMV infections can be detected or only those with viral replication warrants further investigation.

scholarly journals Covid-19 and Acute Kidney Injury: Recent Updates

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Salman Tahir Shafi
Keyword(s):  
Acute Kidney Injury ◽  
Severe Acute Respiratory Syndrome ◽  
World Health Organization ◽  
Recent Literature ◽  
Kidney Injury ◽  
World Health ◽  
Related Disease ◽  
Increased Risk ◽  
The World ◽  
Health Organization

In January 2020, the pathogen was identified and named by the World Health Organization as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). The consequent SARS-CoV-2-related disease was defined as coronavirus disease 2019 (COVID-19). As data emerged about characteristics of the disease, it was found to be associated with increased risk of acute kidney injury (AKI). We explore the recent literature and reports emerging from the epicenters of the pandemic to help our viewers understand the nature of AKI among these patients. 

scholarly journals Acute Kidney Injury in SARS-CoV-2 Infection: Direct Effect of Virus on Kidney Proximal Tubule Cells

2020 ◽  
Vol 21 (9) ◽  
pp. 3275 ◽  
Author(s):  
Manoocher Soleimani
Keyword(s):  
Acute Kidney Injury ◽  
Severe Acute Respiratory Syndrome ◽  
Proximal Tubule ◽  
Rna Viruses ◽  
Kidney Injury ◽  
The Novel ◽  
Proximal Tubule Cells ◽  
Severe Respiratory Infection ◽  
Tubule Cells ◽  
Novel Coronavirus

Coronaviruses (CoVs), including Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and the novel coronavirus disease-2 (SARS-CoV-2) are a group of enveloped RNA viruses that cause a severe respiratory infection which is associated with a high mortality [...]

scholarly journals Management of acute kidney injury in patients with COVID-19 or CKD stage 1-4 patients with acute kidney injury in the COVID-19 pandemic: Adapted clinical guidelines of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists

2020 ◽  
pp. 20-27
Author(s):  
M. Kolesnyk ◽  
I. Dudar ◽  
N. Stepanova ◽  
E. Krasyuk ◽  
Yu. Gonchar ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Acute Kidney Injury ◽  
Mortality Rate ◽  
Medical Care ◽  
Kidney Transplant ◽  
Clinical Guidelines ◽  
Kidney Injury ◽  
Ckd Stage ◽  
Infectious Disease Specialists ◽  
Stage 1

Acute kidney injury (AKI) is diagnosed in 1–40% of the COVID-19 patients; from 2% to 10% of the patients are required renal replacement therapy (RRT). The mortality rate in this category of patients reached 88%. Early AKI detection in the patients with COVID-19, followed by the use of preventive and therapeutic measures to minimize the incidence or progression is a significant key to reduce the mortality rate and transformation of AKI into chronic kidney disease (CKD). The expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created the adapted clinical guidelines for the management of acute kidney injury in patients with COVID-19 or CKD stage 1-4 patients with acute kidney injury in the COVID-19 pandemic. These guidelines are intended for family physicians, general practitioners, physicians, cardiologists, nephrologists, intensivists, endocrinologists, infectious disease specialists and other professionals involved in the provision of specialized medical care to the patients with COVID-19. Specialized medical care for AKI patients infected COVID-19 should be provided by a multidisciplinary team, which has to involve nephrologists, infectious disease specialists and intensivists.

scholarly journals RATING EVALUATION OFSPECIALIZED MEDICAL CARE BYTHEPATIENTSNEPHROLOGIC PROFILE OFTHE UKRAINEPROVINSE

2015 ◽  
pp. 3-8
Author(s):  
M. Kolesnyk ◽  
N. Kozlyuk ◽  
S. Nikolaenko ◽  
N. Stepanova ◽  
Y. Gonchar
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Comparative Analysis ◽  
Kidney Disease ◽  
Medical Care ◽  
Kidney Injury ◽  
Evaluation Methodology ◽  
Use Of Health Care ◽  
Comprehensive Study

The aim of the work was to conduct a comparative analysis of indicators of the performance of nephrological services in the regions of Ukraine by using the method of complex statistical coefficients. Materials and methods. Evaluation of the performance of the system of provision of nephrological services in the regions of Ukraine was made by studying the indicators that characterize the structure, use of health care resources, quality and efficiency of its provision submitted to National Register ofpatients with chronic kidney disease and patients with acute kidney injury (2015). Results. By using rating evaluation methodology, it was identified place of relevant region by each indicator, by each area and by all areas of provision of nephrological services in the region as a whole. Conclusions. As a result of a comprehensive study of the condition of the system of providing nephrological service in the regions, there were identified ranking places of the administrative territories.

scholarly journals Acute kidney injury in non-critical care setting: elaboration and validation of an in-hospital death prognosis score

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Jamal Bamoulid ◽  
Hélène Philippot ◽  
Amir Kazory ◽  
Maria Yannaraki ◽  
Thomas Crepin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Medical Care ◽  
Care Setting ◽  
Diastolic Pressure ◽  
Kidney Injury ◽  
Hospital Death ◽  
Prospective Cohorts ◽  
Time Of Admission ◽  
Prognosis Score ◽  
Glasgow Score

Abstract Background Acute kidney injury (AKI) is still characterized by a high mortality rate. While most patients with AKI are admitted in conventional medical units, current available data are still obtained from studies designed for patients admitted in intensive care units (ICU). Our study aimed to elaborate and validate an in-hospital death prognosis score for AKI admitted in conventional medical care units. Methods We included two prospective cohorts of consecutive patients with AKI admitted between 2001 and 2004 (elaboration cohort (EC)) and between 2010 and 2014 (validation cohort (VC)). We developed a scoring system from clinical and biological parameters recorded at admission from the EC to predict in-hospital mortality. This score was then tested for validation in the VC. Results Three-hundred and twenty-three and 534 patients were included in the EC and VC cohorts, respectively. The proportion of in-hospital death were 15.5% (EC) and 8.9% (VC), mainly due to sepsis. The parameters independently associated with the in-hospital death in the EC were Glasgow score, oxygen requirement, fluid overload, blood diastolic pressure, multiple myeloma and prothrombin time. The in-hospital death prognosis score AUC was 0.845 +/− 0.297 (p < 0.001) after validation in the VC. Conclusions Our in-hospital death prognosis score is the first to be prospectively developed and validated for AKI admitted in a conventional medical care unit. Based on current parameters, easily collected at time of admission, this score could be a useful tool for physicians and nephrologists to determine the in-hospital death prognosis of this AKI population.

scholarly journals Acute kidney injury in the setting of AIDS, bland urine sediment, minimal proteinuria and normal-sized kidneys: a presentation of renal lymphoma

2010 ◽  
Vol 26 (2) ◽  
pp. 747-751 ◽  
Author(s):  
G. Sandhu ◽  
A. Ranade ◽  
P. Mankal ◽  
L. C. Herlitz ◽  
J. Jones ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Urine Sediment ◽  
Renal Lymphoma

scholarly journals Analysis of medical care in Ukraine for nephrological patients in 2019

2020 ◽  
pp. 11-17
Author(s):  
M. O. Kolesnyk ◽  
N. I. Kozliuk ◽  
O. O. Razvazhaieva
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Medical Care ◽  
Kidney Injury ◽  
Financial Decisions ◽  
Quality Of Medical Care ◽  
Nephrological Care

The work aimed to conduct a rating of nephrological services in the regions of Ukraine by using the method of complex statistical coefficients. Methods. Evaluation of nephrological services in the regions of Ukraine was made by using indicators of the structure, health care resources, quality and efficiency of renal medical care of patients with chronic kidney disease and patients with acute kidney injury. Results. The place of each province in the national rating of the state of renal medical care was identified. Conclusions. The organization, availability and quality of medical care for nephrological patients in Ukraine do not meet existing needs. The significant differences in the specialized nephrological care between the regions of Ukraine can be solved out through the implementation of appropriate management and financial decisions.

scholarly journals Identification of fibroblast activation-related genes in two acute kidney injury models

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10926
Author(s):  
Weiming Deng ◽  
Xiangling Wei ◽  
Zhanwen Dong ◽  
Jinhua Zhang ◽  
Zhengyu Huang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Reperfusion Injury ◽  
Ischemia Reperfusion Injury ◽  
Expression Profiles ◽  
Ischemia Reperfusion ◽  
Kidney Injury ◽  
Hub Genes ◽  
Fibroblast Activation ◽  
Qrt Pcr ◽  
Early Activation

BackgroundIschemia-reperfusion injury and drug-induced nephrotoxicity are the two most common reasons for acute kidney injury (AKI). However, little attention has been paid to early activation of fibroblasts in the progression of AKI to chronic kidney disease (CKD). The present study aimed to identify related genes and pathways on fibroblast activation in two mouse models of AKI: ischemia-reperfusion injury (IRI) model and folic acid (FA)-induced injury model.MethodsThe microarray expression profiles ofGSE62732andGSE121190were downloaded from the GEO database, and the differentially expressed genes (DEGs) was analyzed using the Limma package of R software. Principal component analysis (PCA) was also performed using R. The functional information of gene products was annotated by Gene Ontology (GO) and DAVID online database, and the pathway analysis was carried out by using the Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) database. Protein-protein interactions (PPI) network was constructed by STRING and Cytoscape. Furthermore, in the Hypoxia/Reoxygenation (H/R) model, the morphological changes of cells were observed under microscope and the expression of the hub genes in NRK-49F cells were validated by qRT-PCR assays.ResultsA total of 457 DEGs were identified. Among these, 215 DEGs were upregulated and 242 DEGs were downregulated in the acute injured samples compared with uninjured samples. The GO enrichment analysis indicated that these DEGs were mainly involved in transport, the oxidation-reduction process, the metabolic process, metal ion binding, hydrolase activity, and oxidoreductase activity. The KEGG analysis revealed that these DEGs were significantly enriched in the PI3K-Akt signaling pathway, protein digestion and absorption pathway, and focal adhesion pathway. The hub genes including Hnf4α, Pck1 and Timp1 were validated by the qRT-PCR assay in NRK-49F cells in the H/R model.ConclusionsHnf4α, Pck1 and Timp-1 may play a pivotal role in the early activation of fibroblasts, providing novel therapeutic strategies for early prediction and treatment of renal fibrosis.

scholarly journals Detection of SARS-CoV-2 using qRT-PCR in saliva obtained from asymptomatic or mild COVID-19 patients, comparative analysis with matched nasopharyngeal samples

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252964
Author(s):  
Kenji Ota ◽  
Katsunori Yanagihara ◽  
Daisuke Sasaki ◽  
Norihito Kaku ◽  
Naoki Uno ◽  
...  
Keyword(s):  
Viral Load ◽  
Comparative Analysis ◽  
Severe Acute Respiratory Syndrome ◽  
Late Phase ◽  
Cruise Ship ◽  
Rt Pcr ◽  
Load Detection ◽  
Qrt Pcr ◽  
Positive Rate ◽  
Rate Improvement

Objectives The accurate detection of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) is essential for the diagnosis of coronavirus disease 2019 (COVID-19). We compared the quantitative RT-PCR results between nasopharyngeal swabs and saliva specimens. Methods A COVID-19 outbreak occurred on a cruise ship at Nagasaki port, Japan. We obtained 123 nasopharyngeal swabs and saliva each from asymptomatic or mild patients in the late phase of infection. Results The intervals from the diagnosis to the sampling were 25.5 days for nasopharyngeal swabs and 28.9 days for saliva. The positive rate was 19.5% (24/123) for nasopharyngeal swabs and 38.2% (47/123) for saliva (P = 0.48). The quantified viral copies (mean ± SEM copies/5 μl) were 9.3±2.6 in nasopharyngeal swabs and 920±850 in saliva (P = 0.0006). Conclusions The advantages of saliva specimens include positive rate improvement and accurate viral load detection. Saliva may be used as a reliable sample for SARS-CoV-2 detection.

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