title: Renal Complications and Their Prognosis in Korean Patients with Middle East Respiratory Syndrome-Coronavirus from the Central MERS-CoV Designated Hospital.
abstract: Some cases of Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) infection presented renal function impairment after the first MERS-CoV patient died of progressive respiratory and renal failure. Thus, MERS-CoV may include kidney tropism. However, reports about the natural courses of MERS-CoV infection in terms of renal complications are scarce. We examined 30 MERS-CoV patients admitted to National Medical Center, Korea. We conducted a retrospective analysis of the serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine dipstick tests, urinary protein quantitation (ACR or PCR), and other clinical parameters in all patients. Two consecutive results of more than trace (or 1+) of albumin and blood on dipstick test occurred in 18 (60%) (12 [40%]) and 22 (73.3%) (19 [63.3%]) patients, respectively. Fifteen (50.0%) patients showed a random urine ACR or PCR more than 100 mg/g Cr. Eight (26.7%) patients showed acute kidney injury (AKI), and the mean and median durations to the occurrence of AKI from symptom onset were 18 and 16 days, respectively. Old age was associated with a higher occurrence of AKI in the univariate analysis (HR [95% CI]: 1.069 [1.013-1.128], P = 0.016) and remained a significant predictor of the occurrence of AKI after adjustment for comorbidities and the application of a mechanical ventilator. Diabetes, AKI, and the application of a continuous renal replacement therapy (CRRT) were risk factors for mortality in the univariate analysis (HR [95% CI]: diabetes; 10.133 [1.692-60.697], AKI; 12.744 [1.418-114.565], CRRT; 10.254 [1.626-64.666], respectively). Here, we report renal complications and their prognosis in 30 Korean patients with MERS-CoV.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Ran-Hui
authors.identifier: 0000-0003-2783-2600
authors.initials: RH
authors.lastname: Cha
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Joon-Sung
authors.identifier: 0000-0002-5044-2742
authors.initials: JS
authors.lastname: Joh
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Ina
authors.identifier: 0000-0002-0937-9833
authors.initials: I
authors.lastname: Jeong
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Korea.
authors.forename: Ji Yeon
authors.identifier: 0000-0002-7026-8235
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Center for Infectious Diseases, National Medical Center, Seoul, Korea.
authors.forename: Hyoung-Shik
authors.identifier: 0000-0001-6504-3413
authors.initials: HS
authors.lastname: Shin
authors.affiliation: Center for Infectious Diseases, National Medical Center, Seoul, Korea.
authors.forename: Gayeon
authors.identifier: 0000-0001-9788-9800
authors.initials: G
authors.lastname: Kim
authors.affiliation: Center for Infectious Diseases, National Medical Center, Seoul, Korea.
authors.forename: Yeonjae
authors.identifier: 0000-0003-4144-9077
authors.initials: Y
authors.lastname: Kim
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D018352:Coronavirus Infections / Q000150:complications* / Q000503:physiopathology; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006417:Hematuria / Q000209:etiology; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003404:Creatinine
keywords: East Respiratory Syndrome-Coronavirus; Middle; Prognosis; Renal Complication