부산대학교 도서관

COVID-19 is a systemic disease, frequently affecting kidney function. Dexamethasone is standard treatment in severe COVID-19 cases, and is considered to increase plasma levels of cystatin C. However, this has not been studied in COVID-19. Glomerular filtration rate (GFR) is a clinically important indicator of renal function, but often estimated using equations (eGFR) based on filtered metabolites. This study focuses on sources of bias for eGFRs (mL/min) using a creatinine-based equation (eGFR[sub.LMR]) and a cystatin C-based equation (eGFR[sub.CAPA]) in intensive-care-treated patients with COVID-19. This study was performed on 351 patients aged 18 years old or above with severe COVID-19 infections, admitted to the intensive care unit (ICU) in Uppsala University Hospital, a tertiary care hospital in Uppsala, Sweden, between 14 March 2020 and 10 March 2021. Dexamethasone treatment (6 mg for up to 10 days) was introduced 22 June 2020 (n = 232). Values are presented as medians (IQR). eGFR[sub.CAPA] in dexamethasone-treated patients was 69 (37), and 74 (46) in patients not given dexamethasone (p = 0.01). eGFR[sub.LMR] was not affected by dexamethasone. eGFR[sub.LMR] in females was 94 (20), and 75 (38) in males (p = 0.00001). Age and maximal CRP correlated negatively to eGFR[sub.CAPA] and eGFR[sub.LMR], whereas both eGFR equations correlated positively to BMI. In ICU patients with COVID-19, dexamethasone treatment was associated with reduced eGFR[sub.CAPA]. This finding may be explained by corticosteroid-induced increases in plasma cystatin C. This observation is important from a clinical perspective since adequate interpretation of laboratory results is crucial.
Author(s): Anders O. Larsson [1]; Michael Hultström [2,3,4,5]; Robert Frithiof [2]; Ulf Nyman [6]; Miklos Lipcsey [2,7]; Mats B. Eriksson (corresponding author) [2,8,*] 1. Introduction The coronavirus 2 (SARS-CoV-2) has [...]