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The Perspective of Vitamin D on suPAR-Related AKI in COVID-19.

International journal of molecular sciences
January 1, 1970
Tzu-Hsien Liao et al. (7 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to determine whether Vitamin D supplementation could prevent or reduce the severity of acute kidney injury (AKI) in COVID-19 patients by lowering suPAR levels and modulating immune responses.

Results Summary

The study suggests that Vitamin D may attenuate hyperinflammation, reduce suPAR levels, and protect renal function in COVID-19 patients by modulating immunity and inhibiting harmful pathways like the renin-angiotensin-aldosterone system. However, the authors note that further elucidation of the data is needed.

Population

COVID-19 patients, particularly those at risk of or experiencing acute kidney injury (AKI).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Severe vitamin D deficiency
increase
death
people with COVID-19
-
can increase the risk
#1
Vitamin D
decrease
local expression of podocyte uPAR
-
-
attenuates
#2
Vitamin D
decrease
elevated circulating suPAR levels caused by systemic inflammation
-
-
decreases
#3
The attenuated hyperinflammatory state
decrease
complement activation
-
-
reduces
#4
The attenuated hyperinflammatory state
decrease
serum C3a levels
-
-
resulting in lower
#5
Vitamin D
decrease
COVID-19
-
-
can protect against
#6
Vitamin D
neutral
innate and adaptive immunity
-
-
modulating
#7
Vitamin D
increase
ACE2 expression
-
-
increasing
#8
Vitamin D
decrease
the renin-angiotensin-aldosterone system
-
-
inhibiting
#9
appropriate vitamin D supplementation
decrease
AKI
COVID-19 patients
-
could prevent the progression and reduce the severity
#10
Abstract

The coronavirus disease 2019 (COVID-19) pandemic has claimed the lives of millions of people around the world. Severe vitamin D deficiency can increase the risk of death in people with COVID-19. There is growing evidence that acute kidney injury (AKI) is common in COVID-19 patients and is associated with poorer clinical outcomes. The kidney effects of SARS-CoV-2 are directly mediated by angiotensin 2-converting enzyme (ACE2) receptors. AKI is also caused by indirect causes such as the hypercoagulable state and microvascular thrombosis. The increased release of soluble urokinase-type plasminogen activator receptor (suPAR) from immature myeloid cells reduces plasminogen activation by the competitive inhibition of urokinase-type plasminogen activator, which results in low plasmin levels and a fibrinolytic state in COVID-19. Frequent hypercoagulability in critically ill patients with COVID-19 may exacerbate the severity of thrombosis. Versican expression in proximal tubular cells leads to the proliferation of interstitial fibroblasts through the C3a and suPAR pathways. Vitamin D attenuates the local expression of podocyte uPAR and decreases elevated circulating suPAR levels caused by systemic inflammation. This decrease preserves the function and structure of the glomerular barrier, thereby maintaining renal function. The attenuated hyperinflammatory state reduces complement activation, resulting in lower serum C3a levels. Vitamin D can also protect against COVID-19 by modulating innate and adaptive immunity, increasing ACE2 expression, and inhibiting the renin-angiotensin-aldosterone system. We hypothesized that by reducing suPAR levels, appropriate vitamin D supplementation could prevent the progression and reduce the severity of AKI in COVID-19 patients, although the data available require further elucidation.

Medical Subject Headings (MeSH)
Acute Kidney InjuryAngiotensin-Converting Enzyme 2AngiotensinsCOVID-19FibrinolysinHumansPlasminogenReceptors, Urokinase Plasminogen ActivatorSARS-CoV-2ThrombosisUrokinase-Type Plasminogen ActivatorVersicansVitamin DVitaminsCOVID-19 Drug Treatment
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality65/10
Citation Metrics
Total Citations3
Citations/Year1.0
Relative Citation Ratio0.30
NIH Percentile15.8%
Research Impact Scores
APT Score0.25
Weight Score0.67
Normalized Score0.63
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