The following is a summary of “Bioactive adrenomedullin and interleukin-6 in COVID-19: potential biomarkers of acute kidney injury and critical illness,” published in the February 2024 issue of Nephrology by Leininger et al.

Researchers conducted a retrospective study to explore if elevated levels of bioactive adrenomedullin (bio-ADM)  and interleukin-6 (IL-6) predict acute kidney injury (AKI) and critical illness in COVID-19 patients.

They analyzed 153 COVID-19 patients admitted to the emergency department (ED)  with blood samples obtained from each patient. Bio-ADM and IL-6, along with DPP3 and standard markers, were assessed to two endpoints. Firstly, AKI occurred in 22/128 hospitalized patients, and a composite endpoint of admission to the intensive care unit and/or in-hospital death was observed in 26/153 patients.

The results showed that Bio-ADM and IL-6 levels were significantly higher in COVID-19 patients with AKI than those without AKI (P<0.001). ROC analyses revealed AUC values of 0.84 for IL-6 and 0.81 for Bio-ADM in AKI detection. Elevated levels of Bio-ADM and IL-6 were observed in COVID-19 patients who reached the composite endpoint (P<0.001). ROC analysis showed AUC values of 0.89 for IL-6 and 0.83 for Bio-ADM concerning the composite endpoint. In the multivariable logistic model, Bio-ADM and IL-6 emerged as independent predictors for both AKI and the composite endpoint in COVID-19 patients (as well as creatinine for the composite endpoint; all P<0.05), while leukocytes, C-reactive protein (CRP), and dipeptidyl peptidase 3 (DPP3) were not significant (all P=n.s.).

Investigators concluded that elevated bio-ADM and IL-6 emerged as potential risk factors for AKI and critical illness in COVID-19 patients, suggesting their use for early risk assessment in ED.

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03486-1