Urinary cytokines correlate with acute kidney injury in critically ill COVID-19 patients

A Gradin, H Andersson, T Luther, S Bülow Anderberg, S Rubertsson, M Lipcsey, M Åberg, A Larsson, R Frithiof, M Hultström, A Gradin, H Andersson, T Luther, S Bülow Anderberg, S Rubertsson, M Lipcsey, M Åberg, A Larsson, R Frithiof, M Hultström

Abstract

Background: Acute kidney injury is common in COVID-19 patients admitted to the ICU. Urinary biomarkers are a non-invasive way of assaying renal damage, and so far, urinary cytokines are not fully investigated. The current study aimed to assess urinary cytokine levels in COVID-19 patients.

Methods: Urine was collected from COVID-19 patients (n = 29) in intensive care and compared to a preoperative group of patients (n = 9) with no critical illness. 92 urinary cytokines were analyzed in multiplex using the Olink Target 96 inflammation panel and compared to clinical characteristics, and urinary markers of kidney injury.

Results: There were strong correlations between proinflammatory cytokines and between urinary cytokines and urinary kidney injury markers in 29 COVID-19 patients. Several cytokines were correlated to kidney injury, 31 cytokines to AKI stage and 19 cytokines correlated to maximal creatinine.

Conclusions: Urinary inflammatory cytokines from a wide range of immune cell lineages were significantly upregulated during COVID-19 and the upregulation correlated with acute kidney injury as well as urinary markers of kidney tissue damage.

Keywords: Acute kidney injury; Biomarkers; COVID-19; Inflammation; Intensive care; Urine.

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Fig. 1
Fig. 1
Correlation between urinary cytokines detected using the proximity extension assay (black), the urinary kidney damage markers (green) albumin/creatinine-ratio (ACR), kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and acute kidney injury (AKI) in the form of maximal plasma creatinine (red) in critically ill COVID-19 patients (n = 29). Correlations were calculated using Spearman’s correlation, blue indicates positive correlation, red indicates negative correlation. Non-significant correlations are white.

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