Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
권호 표지
DOI QR코드

DOI QR Code

Status of Kidney Function in Hospitalised COVID-19 Patients in the Southern Gyeonggi Province, South Korea

경기 남부 일개 병원에 입원한 코로나 19 환자들의 신기능 현황

  • Kim, Sun-Gyu (Department of Medical Laser, Dankook University Graduate School of Medicine) ;
  • Sung, Hyun Ho (Department of Clinical Laboratory Science, Dongnam Health University)
  • 김선규 (단국대학교 의과대학 의학레이저협동과정) ;
  • 성현호 (동남보건대학교 임상병리과)
  • Received : 2021.08.24
  • Accepted : 2021.09.14
  • Published : 2021.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to investigate the status of renal function in patients with COVID-19. The study surveyed a total of 649 patients hospitalized with COVID-19 at a hospital located in southern Gyeonggi Province, South Korea over a one month period in January 2021. The parameters analyzed were blood urea nitrogen (BUN), creatinine, sodium, potassium, chloride, and estimated glomerular filtration rate (eGFR). The BUN and creatinine of the COVID-19 patients were found to be higher than the normal reference range, specially in males, and in the elderly (60s and 80s or older). The serum electrolyte levels of the patients were observed to be within the reference intervals. Of the subjects, males over 80 years of age had a Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) of 60 mL/min/1.73 m2 or less. Recent research suggests that some severe cases of COVID-19 are showing signs of kidney damage, even in those with no prior underlying kidney disease. Thus, assessment of kidney function using multiple indicators could help diagnose abnormal renal function in patients with COVID-19.

코로나바이러스 감염증 19는 중증급성호흡기증후군 코로나바이러스 2의 명칭에서 명명되었다. 이 연구는 코로나바이러스 감염증 19 환자의 신기능 상태를 조사하는 것을 목적으로 하였다. 본 연구는 경기도 남부 한 병원에서 코로나바이러스 감염증 19로 입원한 649명 환자를 대상으로 하였다. 이번 연구에서 검토한 코로나바이러스 감염증 19 환자의 혈액요소질소와 크레아티닌은 증가된 패턴을 보였다. 본 연구의 대상자 중 남성의 혈액요소질소는 정상 범위보다 높았다. 특히 60대, 80대 이상에서 높게 나타났고, 크레아티닌 수치도 비슷하게 나타났다. 이 연구에서 환자의 전해질 검사는 정상 범위에서 벗어나는 결과는 관찰되지 않았다. 이 연구의 대상에서 80세 이상의 남성은 60 mL/min/1.73 m2 이하의 만성신장질환 역학협력 사구체여과율을 나타냈다. 최근 연구에 따르면 COVID-19의 일부 심각한 사례는 코로나바이러스에 감염되기 전에 기저 신기능의 문제가 없었던 사람들에게도 콩팥 손상의 징후를 보이고 있다. 따라서 여러 지표 평가의 신기능 검사는 검사결과의 검토는 코로나19 환자의 비정상 신기능 발견에 도움이 될 수 있다.

Keywords

References

  1. Pal M, Berhanu G, Desalegn C, Kandi V. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): an update. Cureus, 2020; 12:e7423. https://doi.org/110.7759/cureus.7423
  2. Sifuentes-Rodriguez E, Palacios-Reyes D. COVID-19: the outbreak caused by a new coronavirus. Bol Med Hosp Infant Mex. 2020;77:47-53. https://doi.org/10.24875/BMHIM.20000039
  3. Harapan H, Itoh N, Yufika A, Winardi W, Keam S, Te H, et al. Coronavirus disease 2019 (COVID-19): a literature review. J Infect Public Health. 2020;13:667-673. https://doi.org/10.1016/j.jiph.2020.03.019
  4. Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020;7:11. https://doi.org/10.1186/s40779-020-00240-0
  5. Esakandari H, Nabi-Afjadi M, Fakkari-Afjadi J, Farahmandian N, Miresmaeili SM, Bahreini E. A comprehensive review of COVID-19 characteristics. Biol Proced Online. 2020;22:19. https://doi.org/10.1186/s12575-020-00128-2
  6. Lee SW. Clinical features and treatment of coronavirus disease-19 (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] Infection). J Clinical Otolaryngol. 2020;31:155-163. https://doi.org/10.35420/jcohns.2020.31.2.155
  7. Xian Y, Zhang J, Bian Z, Zhou H, Zhang Z, Lin Z, et al. Bioactive natural compounds against human coronaviruses: a review and perspective. Acta Pharm Sin B. 2020;10:1163-1174. https://doi.org/10.1016/j.apsb.2020.06.002
  8. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020;97:829-838. https://doi.org/10.1016/j.kint.2020.03.005
  9. Su H, Yang M, Wan C, Yi LX, Tang F, Zhu HY, et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int. 2020;98:219-227. https://doi.org/10.1016/j.kint.2020.04.003
  10. Ye M, Wysocki J, William J, Soler MJ, Cokic I, Batlle D. Glomerular localization and expression of angiotensin-converting enzyme 2 and angiotensin-converting enzyme: implications for albuminuria in diabetes. J Am Soc Nephrol. 2006;17:3067-3075. https://doi.org/10.1681/ASN.2006050423
  11. Donoghue M, Hsieh F, Baronas E, Godbout K, Gosselin M, Stagliano N, et al. A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1-9. Circ Res. 2000;87:E1-9. https://doi.org/10.1161/01.res.87.5.e1
  12. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med. 1999;130:461-470. https://doi.org/10.7326/0003-4819-130-6-199903160-00002
  13. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145:247-254. https://doi.org/10.7326/0003-4819-145-4-200608150-00004
  14. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604-612. https://doi.org/10.7326/0003-4819-150-9-200905050-00006
  15. Jager KJ, Kramer A, Chesnaye NC, Couchoud C, Sanchez-Alvarez JE, Garneata L, et al. Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe. Kidney Int. 2020;98:1540-1548. https://doi.org/10.1016/j.kint.2020.09.006
  16. Ronco C, Reis T, Husain-Syed F. Management of acute kidney injury in patients with COVID-19. Lancet Respir Med. 2020;8: 738-742. https://doi.org/10.1016/s2213-2600(20)30229-0
  17. Zakeri R, Pickles A, Carr E, Bean DM, O'Gallagher K, Kraljewic Z, et al. Biological responses to COVID-19: Insights from physiological and blood biomarker profiles. Curr Res Transl Med. 2021;69:103276. https://doi.org/10.1016/j.retram.2021.103276
  18. Chen D, Li X, Song Q, Hu C, Su F, Dai J, et al. Assessment of hypokalemia and clinical characteristics in patients with coronavirus disease 2019 in Wenzhou, China. JAMA Netw Open. 2020;3:e201112.
  19. Inciardi RM, Lupi L, Zaccone G. Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020; 5:819-824. https://doi.org/10.1001/jamacardio.2020.1096
  20. Aggarwal S, Garcia-Telles N, Aggarwal G. Clinical features, laboratory characteristics, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19): Early report from the United States. Diagnosis. 2020;7:91-96. https://doi.org/10.1515/dx-2020-0046
  21. Zahid U, Ramachandran P, Spitalewitz S, Alasadi L, Chakraborti A, Azhar M, et al. Acute kidney injury in COVID-19 patients: an inner city hospital experience and policy implications. 2020;51: 786-796. https://doi.org/10.1159/000511160
  22. Trabulus S, Karaca C, Balkan II, Dincer MT, Murt A, Ozcan SG, et al. Kidney function on admission predicts in-hospital mortality in COVID-19. PLos one. 2020;15:e0238680. https://doi.org/10.1371/journal.pone.0238680
  23. Nugent J, Aklilu A, Yamamoto Y, Simonov M, Li F, Biswas A, et al. Assessment of acute kidney injury and longitudinal kidney function after hospital discharge among patients with and without COVID-19. JAMA Network Open. 2021;4:e211095-211095. https://doi.org/10.1001/jamanetworkopen.2021.1095
  24. Nakajima K, Oda E, Kanda E. The association of serum sodium and chloride levels with blood pressure and estimated glomerular filtration rate. Blood Pressure. 2016;25:51-57. https://doi.org/10.3109/08037051.2015.1090711
  25. Glassock RJ, Winearls C. Ageing and the glomerular filtration rate: truths and consequences. Trans Am Clin Climatol Assoc. 2009;120:419-428.