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Abstract: FR-PO003

Persistently Elevated Urinary Levels of Serpin A3 Appear to Predict Kidney Recovery and Survival in Critically Ill COVID-19 Patients Who Required KRT

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Del Toro-Cisneros, Noemi, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Martinez-Rojas, Miguel Angel, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • González Soria, Isaac, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Ortega-Trejo, Juan Antonio, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Bobadilla, Norma, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Vega, Olynka, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
Background

Numerous studies have suggested a possible role for acute kidney injury (AKI) biomarkers in predicting renal recovery after kidney replacement therapy (KRT) with poor performance. In this study, we investigated urinary SerpinA3 (USerA3) as a biomarker to predict renal recovery (RR) after AKI in critically ill COVID-19 patients with invasive mechanical ventilation (IMV).

Methods

Prospective cohort study of patients with critical COVID-19 in ICU with IMV and who required KRT, admitted to our Institute in Mexico City (Mar 2020 - Feb 2022). Patients with CKD stages 4 or 5 and kidney transplant were excluded. SerpinA3, KIM-1, NGAL and HSP-72 were measured in urine on day 0 (start of KRT) and days 1, 3, 7 and 14. We performed log10 transformation only for urinary USerA3 and, subsequently performed repeated sample ANOVA for each one of the biomarkers.

Results

Sixty patients were included, 52% died before discharge, 38% had complete RR after 90 days and 10% partial RR. Characteristics at baseline for KRT are shown in Table 1. No differences or trends were found in KIM-1 (p=0.380), NGAL (p=0.956), or HSP-72 (p=0.899). In Figure 1 appears USerA3 behavior along the study, showing a clear tendency to be different among the groups. We can observe that the patients who died presented lower amount of USerA3 compared to those who survived. On the other hand, patients with partial RR exhibited USerA3 excretion with a tendency to be lower than those with complete RR, especially in measurements 4 and 5 (day 7 and day 14, respectively).

Conclusion

In this study, we observed that USerA3 seems to be a predictor of RR and survival, which probably reflects a greater renal functional reserve.