{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:48:04Z","timestamp":1787028484934,"version":"build-2736575974"},"reference-count":177,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taipei Tzu Chi Hospital","award":["TCRD-TPE-111-01(1\/3)"],"award-info":[{"award-number":["TCRD-TPE-111-01(1\/3)"]}]},{"name":"Taipei Tzu Chi Hospital","award":["TCRD-TPE-111-RT-4(1\/3)"],"award-info":[{"award-number":["TCRD-TPE-111-RT-4(1\/3)"]}]},{"name":"Taipei Tzu Chi Hospital","award":["WXL-TPE-111-01"],"award-info":[{"award-number":["WXL-TPE-111-01"]}]},{"name":"Tzu Chi Buddhist Health Foundation","award":["TCRD-TPE-111-01(1\/3)"],"award-info":[{"award-number":["TCRD-TPE-111-01(1\/3)"]}]},{"name":"Tzu Chi Buddhist Health Foundation","award":["TCRD-TPE-111-RT-4(1\/3)"],"award-info":[{"award-number":["TCRD-TPE-111-RT-4(1\/3)"]}]},{"name":"Tzu Chi Buddhist Health Foundation","award":["WXL-TPE-111-01"],"award-info":[{"award-number":["WXL-TPE-111-01"]}]},{"name":"The Wu Xiulan Education Foundation","award":["TCRD-TPE-111-01(1\/3)"],"award-info":[{"award-number":["TCRD-TPE-111-01(1\/3)"]}]},{"name":"The Wu Xiulan Education Foundation","award":["TCRD-TPE-111-RT-4(1\/3)"],"award-info":[{"award-number":["TCRD-TPE-111-RT-4(1\/3)"]}]},{"name":"The Wu Xiulan Education Foundation","award":["WXL-TPE-111-01"],"award-info":[{"award-number":["WXL-TPE-111-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>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\u2013angiotensin\u2013aldosterone 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.<\/jats:p>","DOI":"10.3390\/ijms231810725","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T23:16:36Z","timestamp":1663197396000},"page":"10725","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Perspective of Vitamin D on suPAR-Related AKI in COVID-19"],"prefix":"10.3390","volume":"23","author":[{"given":"Tzu-Hsien","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsien-Chang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan"},{"name":"School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Tser","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Taoyuan Armed Forces General Hospital Hsinchu Branch, Hsinchu City 300, Taiwan"},{"name":"Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1360-1422","authenticated-orcid":false,"given":"Wan-Chung","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Medical Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9028-9834","authenticated-orcid":false,"given":"Kuo-Wang","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Chieh","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taoyuan Armed Forces General Hospital Hsinchu Branch, Hsinchu City 300, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7062-8560","authenticated-orcid":false,"given":"Kuo-Cheng","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan"},{"name":"Division of Nephrology, Department of Medicine, Fu-Jen Catholic University Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1681\/ASN.2020030276","article-title":"Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia","volume":"31","author":"Pei","year":"2020","journal-title":"J. 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