Can Biomarkers Predict Kidney Function Recovery and Mortality in Patients with Critical COVID-19 and Acute Kidney Injury?
<b>Background/Objectives</b>: COVID-19 is a systemic viral infection that may lead to serious complications including acute kidney injury that requires kidney replacement therapy. The primary aim of this study was to evaluate urinary SerpinA3 (uSerpinA3) excretion as a biomarker of kidne...
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2025-08-01
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| author | Noemí Del Toro-Cisneros José C. Páez-Franco Miguel A. Martínez-Rojas Isaac González-Soria Juan Antonio Ortega-Trejo Hilda Sánchez-Vidal Norma A. Bobadilla Alfredo Ulloa-Aguirre Olynka Vega-Vega |
| author_facet | Noemí Del Toro-Cisneros José C. Páez-Franco Miguel A. Martínez-Rojas Isaac González-Soria Juan Antonio Ortega-Trejo Hilda Sánchez-Vidal Norma A. Bobadilla Alfredo Ulloa-Aguirre Olynka Vega-Vega |
| author_sort | Noemí Del Toro-Cisneros |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: COVID-19 is a systemic viral infection that may lead to serious complications including acute kidney injury that requires kidney replacement therapy. The primary aim of this study was to evaluate urinary SerpinA3 (uSerpinA3) excretion as a biomarker of kidney recovery at 90 days, and the mortality in patients with critical COVID-19 and AKI requiring kidney replacement therapy (KRT). <b>Methods</b>: The study included patients with critical COVID-19 on invasive mechanical ventilation (IMV) requiring KRT. Blood and urine samples were obtained when KRT was initiated (day zero), and thereafter on days 1, 3, 7, and 14 post-replacement. uSerpinA3, kidney injury molecule-1 (uKIM-1), and neutrophil gelatinase-associated lipocalin (uNGAL) were measured in urine, and interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-α) in peripheral blood. In addition, metabolomics in sample days zero and 3, and in the survivors on sample day 90 was performed by employing gas chromatography coupled with mass spectrometry. <b>Results</b>: A total of 60 patients were recruited, of whom 29 (48%) survived hospitalization and recovered kidney function by day 90. In the survivors, 79% presented complete recovery (CRR) and the remaining (21%) recovered partially (PRR). In terms of uSerpinA3, levels on days 7 and 14 predicted CRR, with AUC values of 0.68 (<i>p</i> = 0.041) and 0.71 (<i>p</i> = 0.030), respectively, as well as mortality, with AUC values of 0.75 (<i>p</i> = 0.007) and 0.76 (<i>p</i> = 0.015), respectively. Among the other biomarkers, the excretion of uKIM-1 on day zero of KRT had a superior performance as a CRR predictor [(AUC, 0.71 (<i>p</i> = 0.017)], and as a mortality predictor [AUC, 0.68 (<i>p</i> = 0.028)]. In the metabolomics analysis, we identified four distinct profiles; the metabolite that maintained statistical significance in predicting mortality was p-cresol glucuronide. <b>Conclusions</b>: This study strongly suggests that uSerpinA3 and uKIM-1 can predict CRR and mortality in patients with critical COVID-19 and AKI requiring KRT. Metabolic analysis appears promising for identifying affected pathways and their clinical impact in this population. |
| format | Article |
| id | doaj-art-79c213fd0dc34a10ade66e3e60cc2d07 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-08-01 |
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| spelling | doaj-art-79c213fd0dc34a10ade66e3e60cc2d072025-08-20T03:36:31ZengMDPI AGDiagnostics2075-44182025-08-011515196010.3390/diagnostics15151960Can Biomarkers Predict Kidney Function Recovery and Mortality in Patients with Critical COVID-19 and Acute Kidney Injury?Noemí Del Toro-Cisneros0José C. Páez-Franco1Miguel A. Martínez-Rojas2Isaac González-Soria3Juan Antonio Ortega-Trejo4Hilda Sánchez-Vidal5Norma A. Bobadilla6Alfredo Ulloa-Aguirre7Olynka Vega-Vega8Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoRed de Apoyo a la Investigación, Universidad Nacional Autónoma de México, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoDepartment of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoDepartment of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoDepartment of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoRed de Apoyo a la Investigación, Universidad Nacional Autónoma de México, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoDepartment of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoRed de Apoyo a la Investigación, Universidad Nacional Autónoma de México, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, MexicoDepartment of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico<b>Background/Objectives</b>: COVID-19 is a systemic viral infection that may lead to serious complications including acute kidney injury that requires kidney replacement therapy. The primary aim of this study was to evaluate urinary SerpinA3 (uSerpinA3) excretion as a biomarker of kidney recovery at 90 days, and the mortality in patients with critical COVID-19 and AKI requiring kidney replacement therapy (KRT). <b>Methods</b>: The study included patients with critical COVID-19 on invasive mechanical ventilation (IMV) requiring KRT. Blood and urine samples were obtained when KRT was initiated (day zero), and thereafter on days 1, 3, 7, and 14 post-replacement. uSerpinA3, kidney injury molecule-1 (uKIM-1), and neutrophil gelatinase-associated lipocalin (uNGAL) were measured in urine, and interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-α) in peripheral blood. In addition, metabolomics in sample days zero and 3, and in the survivors on sample day 90 was performed by employing gas chromatography coupled with mass spectrometry. <b>Results</b>: A total of 60 patients were recruited, of whom 29 (48%) survived hospitalization and recovered kidney function by day 90. In the survivors, 79% presented complete recovery (CRR) and the remaining (21%) recovered partially (PRR). In terms of uSerpinA3, levels on days 7 and 14 predicted CRR, with AUC values of 0.68 (<i>p</i> = 0.041) and 0.71 (<i>p</i> = 0.030), respectively, as well as mortality, with AUC values of 0.75 (<i>p</i> = 0.007) and 0.76 (<i>p</i> = 0.015), respectively. Among the other biomarkers, the excretion of uKIM-1 on day zero of KRT had a superior performance as a CRR predictor [(AUC, 0.71 (<i>p</i> = 0.017)], and as a mortality predictor [AUC, 0.68 (<i>p</i> = 0.028)]. In the metabolomics analysis, we identified four distinct profiles; the metabolite that maintained statistical significance in predicting mortality was p-cresol glucuronide. <b>Conclusions</b>: This study strongly suggests that uSerpinA3 and uKIM-1 can predict CRR and mortality in patients with critical COVID-19 and AKI requiring KRT. Metabolic analysis appears promising for identifying affected pathways and their clinical impact in this population.https://www.mdpi.com/2075-4418/15/15/1960COVID-19acute kidney injurybiomarkersmortalityrenal recovery |
| spellingShingle | Noemí Del Toro-Cisneros José C. Páez-Franco Miguel A. Martínez-Rojas Isaac González-Soria Juan Antonio Ortega-Trejo Hilda Sánchez-Vidal Norma A. Bobadilla Alfredo Ulloa-Aguirre Olynka Vega-Vega Can Biomarkers Predict Kidney Function Recovery and Mortality in Patients with Critical COVID-19 and Acute Kidney Injury? Diagnostics COVID-19 acute kidney injury biomarkers mortality renal recovery |
| title | Can Biomarkers Predict Kidney Function Recovery and Mortality in Patients with Critical COVID-19 and Acute Kidney Injury? |
| title_full | Can Biomarkers Predict Kidney Function Recovery and Mortality in Patients with Critical COVID-19 and Acute Kidney Injury? |
| title_fullStr | Can Biomarkers Predict Kidney Function Recovery and Mortality in Patients with Critical COVID-19 and Acute Kidney Injury? |
| title_full_unstemmed | Can Biomarkers Predict Kidney Function Recovery and Mortality in Patients with Critical COVID-19 and Acute Kidney Injury? |
| title_short | Can Biomarkers Predict Kidney Function Recovery and Mortality in Patients with Critical COVID-19 and Acute Kidney Injury? |
| title_sort | can biomarkers predict kidney function recovery and mortality in patients with critical covid 19 and acute kidney injury |
| topic | COVID-19 acute kidney injury biomarkers mortality renal recovery |
| url | https://www.mdpi.com/2075-4418/15/15/1960 |
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