Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=32695327
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Kormann R
; Jacquot A
; Alla A
; Corbel A
; Koszutski M
; Voirin P
; Garcia Parrilla M
; Bevilacqua S
; Schvoerer E
; Gueant JL
; Namour F
; Levy B
; Frimat L
; Oussalah A
Clin Kidney J
2020[Jun]; 13
(3
): 362-370
PMID32695327
show ga
BACKGROUND: Recent data have shown that severe acute respiratory syndrome
coronavirus 2 can infect renal proximal tubular cells via Angiotensin Converting
Enzyme 2 (ACE2) . Our objective was to determine whether Fanconi syndrome is a
frequent clinical feature in coronavirus disease 2019 (COVID-19) patients.
METHODS: A retrospective cohort of 42 laboratory-confirmed COVID-19 patients
without history of kidney disease hospitalized in University Hospital of Nancy
was investigated. Patients were admitted to the intensive care unit (ICU) (n =
28) or the Medical department (n = 14) and were screened at least once for four
markers of proximal tubulopathy. RESULTS: The mean (standard deviation) follow-up
was 19.7 (±12.2) days. Of the patients, 75% (30/40) showed at least two proximal
tubule abnormalities (incomplete Fanconi syndrome). The main disorders were
proteinuria (88%, n = 35), renal phosphate leak defined by renal phosphate
threshold/glomerular filtration rate (TmPi/GFR) <0.77 (55%, n?=?22),
hyperuricosuria (43%, n?=?17) and normoglycaemic glycosuria (30%, n?=?12). At the
time of the first renal evaluation, ICU patients presented more frequent (96
versus 62%, P?=?0.0095) and more severe (844?±?343 versus 350?±?221 mg/g,
P?=?0.0001) proteinuria, and a trend for an increased number of proximal tubule
abnormalities (P = 0.038). During follow-up, they presented a lower nadir of
serum phosphate [median (interquartile range) 0.68 (0.43-0.76) versus 0.77
(0.66-1.07) mmol/L, P?=?0.044] and Acute kidney Injury (AKI) during the
hospitalization (P?=?0.045). Fanconi syndrome preceded severe AKI KDIGO Stages 2
and 3 in 88% (7/8) of patients. Proximal tubular abnormalities (such as
proteinuria, TmPi/GFR and glycosuria in five, two and two patients, respectively)
were not detected anymore in recovering patients before hospital discharge.
CONCLUSION: Incomplete Fanconi syndrome is highly frequent in COVID-19 patients
and precedes AKI or disappears during the recovery phase.
free
free
free
