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. 2020 Sep 17:14:1179548420959165.
doi: 10.1177/1179548420959165. eCollection 2020.

The Association Between Chronic Kidney Disease and New Onset Renal Replacement Therapy on the Outcome of COVID-19 Patients: A Meta-analysis

Affiliations

The Association Between Chronic Kidney Disease and New Onset Renal Replacement Therapy on the Outcome of COVID-19 Patients: A Meta-analysis

Raymond Pranata et al. Clin Med Insights Circ Respir Pulm Med. .

Abstract

Objective: The aim of the study was to evaluate the association between chronic kidney disease (CKD) and new onset renal replacement therapy (RRT) with the outcome of Coronavirus Disease 2019 (COVID-19) in patients.

Methodology: A systematic literature search from several databases was performed on studies that assessed CKD, use of RRT, and the outcome of COVID-19. The composite of poor outcome consisted of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care, and use of mechanical ventilator.

Results: Nineteen studies with a total of 7216 patients were included. CKD was associated with increased composite poor outcome (RR 2.63 [1.33, 5.17], P = .03; I 2 = 51%, P = .01) and its subgroup, consisting of mortality (RR 3.47 [1.36, 8.86], P = .009; I 2 = 14%, P = .32) and severe COVID-19 (RR 2.89 [0.98, 8.46], P = .05; I 2 = 57%, P = .04). RRT was associated with increased composite poor outcome (RR 18.04 [4.44, 73.25], P < .001; I 2 = 87%, P < .001), including mortality (RR 26.02 [5.01, 135.13], P < .001; I 2 = 60%, P = .06), severe COVID-19 (RR 12.95 [1.93, 86.82], P = .008; I 2 = 81%, P < .001), intensive care (IC) (RR 14.22 [1.76, 114.62], P < .01; I 2 = 0%, P < .98), and use of mechanical ventilator (RR 34.39 [4.63, 255.51], P < .0005).

Conclusion: CKD and new-onset RRT were associated with poor outcome in patients with COVID-19.

Keywords: COVID-19; Chronic kidney disease; Coronavirus; SARS-CoV-2; mortality; renal replacement therapy; severity.

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Conflict of interest statement

Declaration of Conflicting Interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
Figure 2.
Figure 2.
Chronic kidney disease (CKD), renal replacement therapy (RRT), and poor outcome. The forest plot showed that CKD was associated with increased composite poor outcome and its subgroup, which consists of mortality and severe COVID-19 (a). The forest plot showed that RRT was associated with increased composite poor outcome and its subgroup, which consists of mortality, severe COVID-19, intensive care, and the use of mechanical ventilator in COVID-19 (b). Abbreviations: ARDS: acute respiratory distress syndrome; CKD: chronic kidney disease; COVID-19: Coronavirus Disease 2019; IC: intensive care.
Figure 3.
Figure 3.
Funnel plots showed asymmetrical association of both chronic kidney disease (a) and renal replacement therapy (b) with composite poor outcome.

References

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