{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:26:05Z","timestamp":1791329165685,"version":"4.3.1"},"reference-count":54,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Acute kidney injury (AKI) has emerged as a significant complication in patients with coronavirus disease 2019 (COVID-19). The pathophysiology of COVID-19-associated AKI is multifactorial, involving both direct viral effects on renal cells and indirect mechanisms such as systemic inflammation and cytokine storms. This highlights the critical need for early detection and effective management strategies to mitigate kidney injury and improve patient outcomes. The aim of our study is to assess the potential predictive role of inflammatory biomarkers in determining the risk of developing COVID-19-associated AKI in patients with and without pre-existing CKD. Methods: This study included 84 patients stratified by pre-existing chronic kidney disease (CKD) status. Demographic, clinical, and laboratory data were collected, including vital signs, hematological profiles, renal function markers, inflammatory biomarkers, coagulation parameters, and treatments. Outcomes such as acute kidney injury (AKI) and in-hospital mortality were documented. Results: In patients with pre-existing CKD, IL-6 and NLR demonstrated high predictive accuracy for AKI onset. In patients without pre-existing CKD, white blood cell (WBC) count emerged as a significant predictor of AKI onset. Conclusions: The differential roles of IL-6, NLR, and WBC in predicting AKI onset highlight distinct physiopathological pathways influenced by COVID-19. In CKD+ patients, chronic inflammation and immune dysregulation are key drivers of AKI, with IL-6 and NLR serving as robust markers of this inflammatory state. In contrast, in CKD\u2212 patients, AKI may be more influenced by acute inflammatory responses and infectious factors, as reflected by WBC count.<\/jats:p>","DOI":"10.3390\/life15050720","type":"journal-article","created":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T20:42:37Z","timestamp":1746391357000},"page":"720","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Predictive Biomarkers of Acute Kidney Injury in COVID-19: Distinct Inflammatory Pathways in Patients with and Without Pre-Existing Chronic Kidney Disease"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6767-8823","authenticated-orcid":false,"given":"Caterina","family":"Carollo","sequence":"first","affiliation":[{"name":"Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8609-0814","authenticated-orcid":false,"given":"Alida","family":"Benfante","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Sorce","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia","family":"Montalbano","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4934-0818","authenticated-orcid":false,"given":"Emanuele","family":"Cirafici","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Calandra","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3806-1151","authenticated-orcid":false,"given":"Giulio","family":"Geraci","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, \u201cKore\u201d University of Enna, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Mul\u00e8","sequence":"additional","affiliation":[{"name":"Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6400-6573","authenticated-orcid":false,"given":"Nicola","family":"Scichilone","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"ref_1","unstructured":"(2025, April 05). 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