Tumor necrosis factor receptor (TNFR)-1 and TNFR-2 plasma levels are robust predictors for major adverse kidney events (MAKE) in patients hospitalized with COVID-19, according to data presented during Kidney Week 2021.

These biomarkers were among 15 found to be significantly associated with either a decreased or increased risk for MAKE, defined as KDIGO stage 3 acute kidney injury (AKI), dialysis-requiring AKI, or in hospital mortality.

Steven Menez, MD, MHS, of Johns Hopkins University School of Medicine in Baltimore, Maryland, and colleagues studied 576 patients (243, or 42%, women) hospitalized with COVID-19 from April to September 2020 at Johns Hopkins Hospital, Yale New Haven Hospital in New Haven, Connecticut, and Mount Sinai Hospital in New York, New York. They evaluated 26 candidate plasma biomarkers.


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Each 1 standard deviation increase in TNFR-1 and TNFR-2 was significantly associated with a 2.26- and 2.30-fold increased risk for MAKE, respectively, after adjusting for age, sex, race, and other potential confounders, Dr Menez’s team reported. TNFR-1 and TNFR-2 provided very strong discrimination in identifying patients who will or will not experience MAKE, with area under the curve (AUC) values of 0.88 and 0.83, respectively.

Addition of clinical variables to TNFR-1 and TNFR-2 increased the AUC values to 0.91 and 0.89, respectively. Using all 15 biomarkers together had an AUC of 0.87 for predicting MAKE.

The study population had a mean age of 60.3 years. Of the 576 patients, 203 (35%) had diabetes mellitus, 293 (51%) had hypertension, and 168 (29%) were obese. MAKE developed in 95 patients (16%) within 60 days of hospital admission.

Reference

Menez S, Coca SG, Moledina DG, et al. Plasma biomarkers predict major adverse kidney events in hospitalized patients with COVID-19. Presented at Kidney Week 2021, November 2-7, 2021. Poster PO0013.