The value of urinalysis in predicting acute kidney injury and mortality in COVID-19 patients

Abstract

Kidney involvement is frequent among patients with coronavirus disease 2019 (COVID-19). However, kidney involvement is varied and mild kidney injury can easily go unnoticed. We aimed to investigate the urinalysis data of COVID-19 patients on admission and to explore the value of urinalysis in the prediction of acute kidney injury (AKI) and in-hospital mortality in patients with COVID-19. Methods. The demographic, clinical and laboratory data of patients with confirmed COVID-19 were retrospectively collected from the electronic health records of the hospital. The outcomes were the development of AKI and in-hospital mortality. Results. 244 patients were included in the analysis. The mean age was 59.6 ± 13.7 and 65.2% of patients were male. Serum creatinine on admission was 0.86 (0.72-1.05) mg/dL. Glucosuria, proteinuria and hematuria were found in 36.1%, 22.9% and 22.1% of patients, respectively. AKI was detected in 63 patients (25.8%) at any time of hospitalization. According to multivariate analysis, AKI development was associated with higher WBC and decreased eGFR as well as with proteinuria on admission. During median 8 (IQR, 5-12) days of follow-up, 33 patients (13.5%) died. Older age, higher C-reactive protein levels and proteinuria on admission were also independent predictors of in-hospital mortality. Conclusion. Proteinuria on admission was associated with the development of AKI and in-hospital mortality in patients with COVID-19. Urinalysis can be useful for early diagnosis of kidney damage before serum creatinine rise and mortality prediction in COVID-19 patients.