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10.1093/ckj/sfaa109

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C7314200!7314200!32695327
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suck abstract from ncbi


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pmid32695327      Clin+Kidney+J 2020 ; 13 (3): 362-70
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  • Coronavirus disease 2019: acute Fanconi syndrome precedes acute kidney injury #MMPMID32695327
  • 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): 362-70 PMID32695327show 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.
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