Статья

Nephrinuria as an Early Biomarker of Renal Injury in Hypertensive Patients After COVID-19: A Comparative Study

Gulomjon KholovDepartment of Nephrology and Hemodialysis, Bukhara State Medical Institute, Bukhara 200100, UzbekistanNilufar AkhmedovaDepartment of Nephrology and Hemodialysis, Bukhara State Medical Institute, Bukhara 200100, UzbekistanUlugbek OchilovHistory and Foreign Languages Department, Asia International University, Bukhara 200100, UzbekistanSukhrob NurulloyevDepartment of Nephrology and Hemodialysis, Bukhara State Medical Institute, Bukhara 200100, UzbekistanSitora MukhammadiyevaDepartment of Nephrology and Hemodialysis, Bukhara State Medical Institute, Bukhara 200100, UzbekistanNozima DjuraevaDepartment of Nephrology and Hemodialysis, Bukhara State Medical Institute, Bukhara 200100, UzbekistanOtabek FayzulloyevInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanAbdugappor InsopovThe Latest History of Uzbekistan, National University of Uzbekistan, Tashkent 100174, UzbekistanSanobar RakhmonovaDepartment of Nephrology and Hemodialysis, Bukhara State Medical Institute, Bukhara 200100, UzbekistanMehriniso OchilovaInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanRajab BOBOKALONOVInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanAkmal DjumaevInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanZulfiya AbulovaInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanDildora OtajonovaInterfaculty Department of Foreign Languages, Chirchik State Pedagogical University, Chirchik 702100, UzbekistanMokhibegim NematovaInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanNigina SHUKUROVAInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanNavbakhor NazarovaInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanDildora KomilovaDepartment of Western Languages, Tashkent State University of Oriental Studies, Tashkent 100174, UzbekistanMehinbonu NurmukhammedovaInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, UzbekistanDilfuza RAKHMONOVAInterfaculty Department of Foreign Languages, Bukhara State University, Bukhara 200100, Uzbekistan

COVIDjournal2026en

ABI

Аннотация

Background: Hypertension is one of the most prevalent comorbidities in patients with COVID-19 and a major contributor to chronic kidney disease (CKD). Traditional kidney injury markers, including creatinine, estimated glomerular filtration rate (eGFR) and microalbuminuria, reflect renal injury only after substantial nephron loss has already occurred. Urinary podocyte proteins, such as nephrin (nephrinuria), have been suggested as early markers of glomerular barrier dysfunction; however, their clinical behavior and diagnostic value in hypertensive patients with previous SARS-CoV-2 infection are unknown. Aim: To assess urinary nephrinuria, microalbuminuria, transforming growth factor β1 (TGF-β1), aldosterone, vascular endothelial growth factor A (VEGF-A) and renal hemodynamics across different stages of hypertension in patients with and without a history of COVID-19 and to assess the response to conventional antihypertensive and nephroprotective treatment. Methods: In a prospective comparative cohort study, 120 patients (aged 30–60 years) with stage I–III essential hypertension were stratified by COVID-19 history into a post-COVID-19 group (n = 60) and a non-COVID-19 group (n = 60); within each group, 20 patients were assigned to each hypertension stage. Comparisons were performed between the post-COVID-19 and non-COVID-19 subgroups at the same hypertension stage. Serum creatinine, cystatin-C, aldosterone, TGF-β1 and VEGF-A, urinary microalbumin and nephrin and intrarenal Doppler hemodynamics were measured at baseline and after six months of guideline-based treatment. Results: Nephrinuria was markedly increased in post-COVID-19 patients in all stages of hypertension, including stage I, where serum creatinine, cystatin-C and eGFR were within the normal range (126.5 ± 9.1 vs. 91.9 ± 8.3 pg/mL, p < 0.01). Nephrinuria was strongly correlated with renal functional reserve (r = −0.824, p < 0.001), eGFR (r = −0.797, p < 0.001), microalbuminuria (r = 0.758, p < 0.001), aldosterone (r = 0.613, p < 0.001) and VEGF-A (r = 0.589, p < 0.001). Antihypertensive and nephroprotective treatment for six months decreased nephrinuria, blood pressure and TGF-β1, with more limited effects in stage III disease. Conclusions: Nephrinuria was found to be an early marker of renal involvement in COVID-19, occurring before microalbuminuria and conventional functional markers and with a greater relative difference than these markers in stage I disease, suggesting podocyte injury as an early and potentially reversible mechanism of post-COVID renal involvement in hypertensive patients. Nephrinuria seems to be a potential biomarker for early renal surveillance in this population and its prognostic role for incident CKD needs to be validated in longitudinal outcome studies.

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Темы

COVID-19 Clinical Research Studies Renal Diseases and Glomerulopathies Chronic Kidney Disease and Diabetes

Идентификаторы

DOI: 10.3390/covid6050087

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Показатели — AkademScholar