ABSTRACT Purpose 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 AKI and in-hospital mortality in patients with Covid-19. Methods The demographic, clinical and laboratory data of patients with confirmed Covid-19 were collected from the electronic health records of the hospital. The outcomes were development of AKI and in-hospital mortality. Results 244 patients were included in the analysis. Mean age was 59.6 ± 13.7 and 65.2% of patients were male. Median SCr 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%) on any time of hospitalization. According to multivariate binary logistic regression analayses; 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 CRP levels and proteinuria on admission were also independent predictors of in-hospital mortaliy. Conclusion Proteinuria on admission is associated with development of AKI and in-hospital mortality in patients with Covid-19. Urinalysis can be useful for the evaluation of COVID-19 progression and early diagnosis of kidney damage before SCr rise.

Introduction Data on antibody response following COVID-19 in kidney transplant recipients is scarce. We performed a cross-sectional study to investigate antibody response to COVID-19 among kidney transplant recipients. Design We recruited 46 kidney transplant recipients with RT-PCR confirmed COVID-19 and 45 recipients without COVID-19 history. We also constructed two control groups (COVID-19 positive and negative) from a historical cohort of health care workers. We used age and sex-based propensity score matching to select eligible subjects to control groups. We measured SARS-Cov-2 IgG levels quantitatively using the Abbott ARCHITECT system. An antibody level above 1.4 S/C defined positivity. Results Transplant recipients with COVID-19 had a higher BMI, and COVID-19 history in a household member was more common than that of the transplant recipient without COVID-19. IgG seropositivity rate (69.6% vs 78.3%, p=0.238) and median IgG level (3.28 [IQR 0.80-5.85] vs 4.59 [1.61-6.06], p=0.499) were similar in COVID-19 positive transplant recipients and controls. There was a trend toward lower antibody levels in kidney transplant recipients associated with a longer duration between RT-PCR and antibody testing (r=-0.532, p<0.001). Conclusion At the early post-COVID-19 period, transplant recipients have an antibody response that is similar to controls. However, antibody levels and associated immunity should be closely observed with longer follow-up durations.

Background Real-life data on the predialysis management of chronic kidney disease (CKD) is scarce. We aimed to investigate the current clinical practice and compliance among nephrologists with KDIGO CKD mineral bone disorders (MBD) guidelines. Methods We performed a multicenter cross-sectional study. We recruited stage 3-5 non-dialysis (ND) CKD patients and recorded data related to CKD MBD from two consecutive outpatient clinical visits apart 3 to 6 months. We calculated therapeutic inertia for hyperphosphatemia, hypocalcemia, hyperparathyroidism, and hypovitaminosis D and overtreatment for hypophosphatemia, hypercalcemia, hypoparathyroidism, and hypervitaminosis D. Results We examined a total of 302 patients (male: 48.7%, median age: 67 years). The persistence of low 25-OH vitamin D levels (61.7%) was the most common laboratory abnormality related to CKD-MBD, followed by hyperparathyroidism (14.8%), hyperphosphatemia (7.9%), and hypocalcemia (0.0%). According to our results, therapeutic inertia seems to be a more common problem than overtreatment for all the CKD-MBD laboratory parameters that we examined. Therapeutic inertia frequency was highest for hypovitaminosis D (81.1%), followed by hypocalcemia (75.0%), hyperparathyroidism (59.0%), and hyperphosphatemia (30.4%), respectively. Conclusion We found that CKD-MBD is not optimally managed in CKD stage 3-5 ND patients. Clinicians should have an active attitude regarding the correction of MBD even at the earlier stages of CKD.