1. Apa peranan urin biomarker dalam mendiagnosis kerusakan ginjal pada pasien covid-19 tersebut?

Biomarkers of kidney injury, inflammation, and repair may offer further insight beyond current
standard methods of characterizing COVID-19–associated AKI. Biomarkers can help to differentiate
various types of kidney injury14,15 and may be uniquely helpful in quantifying tubular injury in
COVID-19. In this study, therefore, we explored the association of urinary biomarkers of kidney
injury, inflammation, and repair with severe AKI and death in patients hospitalized with COVID-19.

2. Pada pasien seperti apa yg merupakan high risk untuk terjadinya kerusakan ginjal pada pasien
covid 19?

Risk factors for the development of AKI in the setting of COVID-19 include Black race, male sex,
age over 50 years, diabetes mellitus, hypertension, obesity, and heart failure.9,11 We showed,
however, that even after adjusting for such risk factors, patients with COVID-19 have a more than
40% higher risk of AKI compared with patients without COVID-19.7 The mechanism for this higher
AKI risk remains unexplained

3. Apakah pemeriksaan urin biomarker ini dapat dijadikan pertanda bahwa akan terjadi kerusakan
ginjal pada pasien covid tersebut?

we have shown that urinary biomarkers can help identify the patients who are hospitalized with
COVID-19 who are at high risk for adverse kidney outcomes and death. These findings may
improve the risk stratification of patients admitted with COVID-19. The degree of tubular injury
and inflammation does not appear to be overtly higher than in other common settings of AKI.
Subclinical AKI, as defined by elevations in urinary biomarkers, was present in 30%-50% of
individuals who did not manifest clinical AKI. Further studies are needed to validate these findings
and assess the association of the biomarkers with risk for CKD as well as the potential longterm
consequences associated with subclinical AKI after COVID-19

4. Bagaimana peranan covid 19 dalam merusak ginjal ?

Concluded that the pathogenesis of COVID-19–associated AKI is not yet fully elucidated and is
likely multifactorial. Endothelial dysfunction, coagulopathy, complement activation, systemic
inflammation, and immune dysfunction may all play a role in disease pathogenesis affecting the
kidney.

5. Apakah ada perbedaan hasil analisis biomarker antara kasus AKI pada covid 19 dengan AKI pada
kondisi medis lainnya?

Nearly 100% of patients with COVID-19–associated AKI, regardless of stage, had urinary IL-18 and
MCP-1 levels above the 90th percentile of reference values . Similarly, over 50% of patients with
COVID-19–associated AKI had urinary NGAL levels above the 90th percentile of reference values.
In general, the degree of kidney injury based on biomarker levels above the reference
preoperative level was generally similar in COVID-19–associated AKI compared with other AKI
settings. Markers of injury and inflammation, namely IL-18 and MCP-1, were relatively more
elevated than markers of glomerular injury (albumin) or tubular health (UMOD) in the setting of
COVID-19. In general, the relative degree of kidney injury in those with COVID-19–associated AKI
by NGAL or KIM-1 level was slightly higher than in those with exercise stress-induced AK

6. Apakah ada perbedaan tatalaksana dari masing2 biomarker yang di temukan pada kasus2 AKI?

Sampai saat ini belum ada perbedaan penatalaksanaan