@article{3103645,
    title = "Soluble urokinase receptor (SuPAR) in COVID-19-Related AKI",
    author = "Azam, T.U. and Shadid, H.R. and Blakely, P. and O'Hayer, P. and Berlin, H. and Pan, M. and Zhao, P. and Zhao, L. and Pennathur, S. and Pop-Busui, R. and Altintas, I. and Tingleff, J. and Stauning, M.A. and Andersen, O. and Adami, M.-E. and Solomonidi, N. and Tsilika, M. and Tober-Lau, P. and Arnaoutoglou, E. and Keitel, V. and Tacke, F. and Chalkias, A. and Loosen, S.H. and Giamarellos-Bourboulis, E.J. and Eugen-Olsen, J. and Reiser, J. and Hayek, S.S. and Hayek, S.S. and Blakely, P. and Berlin, H. and Azam, T.U. and Shadid, H. and Pan, M. and O'Hayer, P. and Meloche, C. and Feroze, R. and Padalia, K.J. and Anderson, E. and Perry, D. and Bitar, A. and Kaakati, R. and Zhao, L. and Zhao, P. and Eugen-Olsen, J. and Altintas, I. and Tingleff, J. and Stauning, M. and Houlind, M.B. and Lindstrøm, M.B. and Andersen, O. and Gamst-Jensen, H. and Rasmussen, L.J.H. and Rasmussen, C. and Nehlin, J.O. and Kallemose, T. and Parvaiz, I. and Giamarellos-Bourboulis, E.J. and Adami, M.-E. and Solomonidi, N. and Tsilika, M. and Saridaki, M. and Lekakis, V. and Loosen, S. and Luedde, T. and Keitel, V. and Arnaoutoglou, E. and Pantazopoulos, I. and Laou, E. and Kolonia, K. and Skoulakis, A. and Tacke, F. and Tober-Lau, P. and Mohr, R. and Kurth, F. and Sander, L.E. and Jochum, C. and International Study of Inflammation in COVID-19",
    journal = "Journal of the American Society of Nephrology",
    year = "2020",
    volume = "31",
    number = "11",
    pages = "2725-2735",
    publisher = "American Society of Nephrology",
    issn = "1046-6673, 1533-3450",
    doi = "10.1681/ASN.2020060829",
    keywords = "biological marker;  C reactive protein;  creatinine;  D dimer;  ferritin;  lactate dehydrogenase;  urokinase receptor;  PLAUR protein, human;  urokinase receptor, acute kidney failure;  adult;  age;  Article;  Black person;  body mass;  cohort analysis;  congestive heart failure;  coronavirus disease 2019;  creatinine blood level;  diabetes mellitus;  estimated glomerular filtration rate;  female;  ferritin blood level;  hospital admission;  hospital patient;  hospitalization;  human;  hypertension;  incidence;  inflammation;  kidney function;  lactate dehydrogenase blood level;  major clinical study;  male;  middle aged;  multicenter study;  obese patient;  observational study;  oxygen saturation;  priority journal;  protein blood level;  receiver operating characteristic;  renal replacement therapy;  sex difference;  acute kidney failure;  aged;  Betacoronavirus;  blood;  clinical trial;  complication;  Coronavirus infection;  pandemic;  very elderly;  virus pneumonia, Acute Kidney Injury;  Adult;  Aged;  Aged, 80 and over;  Betacoronavirus;  Coronavirus Infections;  Female;  Humans;  Incidence;  Male;  Middle Aged;  Pandemics;  Pneumonia, Viral;  Receptors, Urokinase Plasminogen Activator",
    abstract = "Background AKI commonly occurs in patients with coronavirus disease 2019 (COVID-19). Its pathogenesis is poorly understood. The urokinase receptor system is a key regulator of the intersection between inflammation, immunity, and coagulation, and soluble urokinase plasminogen activator receptor (suPAR) has been identified as an immunologic risk factor for AKI. Whether suPAR is associated with COVID-19-related AKI is unknown. Methods In a multinational observational study of adult patients hospitalized for COVID-19, we measured suPAR levels in plasma samples from 352 adult patients that had been collected within 48 hours of admission. We examined the association between suPAR levels and incident in-hospital AKI. Results Of the 352 patients (57.4% were male, 13.9% were black, and mean age was 61 years), 91 (25.9%) developed AKI during their hospitalization, of whom 25 (27.4%) required dialysis. The median suPAR level was 5.61 ng/ml. AKI incidence rose with increasing suPAR tertiles, from a 6.0% incidence in patients with suPAR,4.60 ng/ml (first tertile) to a 45.8% incidence of AKI in patients with suPAR levels.6.86 ng/ml (third tertile). None of the patients with suPAR,4.60 ng/ml required dialysis during their hospitalization. In multivariable analysis, the highest suPAR tertile was associated with a 9.15-fold increase in the odds of AKI (95% confidence interval [95% CI], 3.64 to 22.93) and a 22.86-fold increase in the odds of requiring dialysis (95% CI, 2.77 to 188.75). The association was independent of inflammatory markers and persisted across subgroups. Conclusions Admission suPAR levels in patients hospitalized for COVID-19 are predictive of in-hospital AKI and the need for dialysis. SuPAR may be a key component of the pathophysiology of AKI in COVID-19. Copyright © 2020 by the American Society of Nephrology"
}