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Observational Study
. 2021 Apr;34(2):355-364.
doi: 10.1007/s40620-020-00931-w. Epub 2021 Jan 23.

Proteinuria in COVID-19: prevalence, characterization and prognostic role

Justine Huart  1   2 , Antoine Bouquegneau  1 , Laurence Lutteri  3 , Pauline Erpicum  1   2 , Stéphanie Grosch  1 , Guillaume Résimont  1 , Patricia Wiesen  4 , Christophe Bovy  1 , Jean-Marie Krzesinski  1   2 , Marie Thys  5 , Bernard Lambermont  4 , Benoît Misset  4 , Hans Pottel  6 , Christophe Mariat  7 , Etienne Cavalier  3 , Stéphane Burtey  8   9 , François Jouret  1   2 , Pierre Delanaye  10   11
Affiliations
Observational Study

Proteinuria in COVID-19: prevalence, characterization and prognostic role

Justine Huart et al. J Nephrol. 2021 Apr.

Abstract

Background: Proteinuria has been commonly reported in patients with COVID-19. However, only dipstick tests have been frequently used thus far. Here, the quantification and characterization of proteinuria were investigated and their association with mortality was assessed.

Methods: This retrospective, observational, single center study included 153 patients, hospitalized with COVID-19 between March 28th and April 30th, 2020, in whom total proteinuria and urinary α1-microglobulin (a marker of tubular injury) were measured. Association with mortality was evaluated, with a follow-up until May 7th, 2020.

Results: According to the Kidney Disease Improving Global Outcomes staging, 14% (n = 21) of the patients had category 1 proteinuria (< 150 mg/g of urine creatinine), 42% (n = 64) had category 2 (between 150 and 500 mg/g) and 44% (n = 68) had category 3 proteinuria (over 500 mg/g). Urine α1-microglobulin concentration was higher than 15 mg/g in 89% of patients. After a median follow-up of 27 [14;30] days, the mortality rate reached 18%. Total proteinuria and urinary α1-microglobulin were associated with mortality in unadjusted and adjusted models. This association was stronger in subgroups of patients with normal renal function and without a urinary catheter.

Conclusions: Proteinuria is frequent in patients with COVID-19. Its characterization suggests a tubular origin, with increased urinary α1-microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.

Keywords: COVID-19; Proteinuria; Tubular proteinuria; α1-microglobulin.

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Conflict of interest statement

All the authors declare that they have no conflict of interest involving the work under consideration for publication.

Figures

Fig. 1
Fig. 1
Survival curve according to proteinuria categorization (a), urine α1-microglobulin (b) or presence of hematuria (c)
See this image and copyright information in PMC

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