Kidney & Blood Pressure Research (Nov 2023)

Endothelial biomarkers in critically-ill COVID-19 patients: potential predictors of the need for dialysis

  • Marza de Sousa Zaranza,
  • Gdayllon Cavalcante Meneses,
  • Reinaldo Barreto Oriá,
  • Alice Maria Costa Martins,
  • Natalia Linhares Ponte Aragão,
  • Nilcyeli Linhares Aragão,
  • Saskya Roberta Rodrigues de Andrade,
  • Nicole Coelho Lopes,
  • Letícia Machado de Araújo,
  • Ranieri Sales de Souza Santos,
  • Álvaro Rolim Guimarães,
  • Ana Paula Pires Lázaro,
  • Andrea Mazza Beliero,
  • Márcia Maria Pinheiro Dantas,
  • Sandra Mara Brasileiro Mota,
  • Geraldo Bezerra da Silva Júnior,
  • Polianna Lemos Moura Moreira Albuquerque,
  • Elizabeth De Francesco Daher

DOI
https://doi.org/10.1159/000535035

Abstract

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Introduction: To evaluate the function of vascular biomarkers to predict need for hemodialysis in critically-ill patients with COVID-19. Methods: This is a prospective study with 58 critically-ill patients due to COVID-19 infection. Laboratory tests in general and vascular biomarkers, such as VCAM-1, Syndecan-1, Angiopoietin-1 and Angiopoeitin-2 were quantified on intensive care unit (ICU) admission. Results: There was a 40% death rate. VCAM and Ang-2/Ang-1 ratio on ICU admission were associated with need for hemodialysis. Vascular biomarkers (VCAM-1, Syndecan-1, angiopoetin-2/ anogiopoetin-1 ratio) were predictors of death and their cut-off values were useful to stratify patients with a worse prognosis. In the multivariate cox regression analysis with adjusted models, VCAM-1 [O.R. 1.13 (C.I. 95%: 1.01 - 1.27); p= 0.034] and Ang-2/Ang-1 ratio [O.R. 4.87 (C.I.95%: 1.732 - 13.719); p= 0.003] were associated with need for dialysis. Conclusion: Vascular biomarkers, mostly VCAM-1 and Ang-2/Ang-1 ratio, showed better efficiency to predict need for hemodialysis in critically-ill COVID-19 patients.