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Meta-Analysis
. 2021 Jan:90:107159.
doi: 10.1016/j.intimp.2020.107159. Epub 2020 Nov 3.

Acute kidney injury and renal replacement therapy in COVID-19 patients: A systematic review and meta-analysis

Xiaopeng Yang  1 , Shasha Tian  1 , Hui Guo  2
Affiliations
Meta-Analysis

Acute kidney injury and renal replacement therapy in COVID-19 patients: A systematic review and meta-analysis

Xiaopeng Yang et al. Int Immunopharmacol. 2021 Jan.

Abstract

Purpose: Reported rates of acute kidney injury (AKI) have varied significantly among studies of coronavirus disease 2019 (COVID-19) published to date. The present meta-analysis was conducted to gain clarity regarding AKI incidence and renal replacement therapy (RRT) use in COVID-19 patients.

Methods: The PubMed, Embase, Web of Science, medRxiv, and bioRxiv databases were systematically searched for COVID-19-related case reports published through 25 July 2020. Pooled analyses were conducted using R.

Results: The pooled incidence of AKI in 51 studies including 21,531 patients was 12.3% (95% CI 9.5-15.6%), with higher rates of 38.9% in 290 transplant patients (95% CI 27.3-51.9%), 39.0% in 565 ICU patients (95% CI 23.2-57.6%) and 42.0% among 1745 deceased patients (95% CI 30.3-54.7%). RRT usage was reported in 39 studies of 17,664 patients, with an overall pooled use of 5.4% (95% CI 4.0-7.1%), with higher rates of 15.6% in 117 transplant patients (95%CI 9.9-23.8%) and 16.3% in 776 ICU patients (95% CI 11.1-23.3%).

Conclusion: AKI and RRT use among COVID-19 patients represent a major public health concern, and early and appropriate intervention should be called upon to improve the prognosis of patients suffering from AKI.

Keywords: Acute kidney injury; COVID-19; Renal replacement therapy.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram.
Fig. 2a
Fig. 2a
Forest plot depicting the incidence of AKI in COVID-19 patients.
Fig. 2b
Fig. 2b
Subgroup analysis depicting the incidence of AKI in COVID-19 patients.
Fig. 2c
Fig. 2c
Subgroup analysis depicting the incidence of AKI between different continents in COVID-19 patients.
Fig. 2d
Fig. 2d
Forest plot depicting the incidence of AKI in COVID-19 patients in China.
Fig. 2e
Fig. 2e
Forest plot depicting the incidence of AKI in COVID-19 patients in the USA.
Fig. 2f
Fig. 2f
Forest plot depicting the incidence of AKI in intensive care unit Patients.
Fig. 2g
Fig. 2g
Forest plot depicting the incidence of AKI in deaths.
Fig. 3a
Fig. 3a
Forest plot depicting the incidence of RRT use in COVID-19 patients.
Fig. 3b
Fig. 3b
Subgroup analysis depicting the incidence of RRT use in COVID-19 patients.
Fig. 3c
Fig. 3c
Forest plot depicting the incidence of RRT use in intensive care unit Patients.
See this image and copyright information in PMC

References

    1. Drosten C., Günther S., Preiser W., van der Werf S., Brodt H.R., Becker S., et al. Identification of a Novel Coronavirus in patients with severe acute respiratory syndrome. N. Engl. J. Med. 2003;348(20):1967–1976. doi: 10.1056/NEJMoa030747. - DOI - PubMed
    1. Zaki A.M., van Boheemen S., Bestebroer T.M., Osterhaus A.D., Fouchier R.A. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N. Engl. J. Med. 2012;367(19):1814–1820. doi: 10.1056/NEJMoa1211721. - DOI - PubMed
    1. Munster V.J., Koopmans M., van Doremalen N., van Riel D., de Wit E. Novel Coronavirus emerging in China -key questions for impact assessment. N. Engl. J. Med. 2020;3828(8) doi: 10.1056/NEJMp2000929. - DOI - PubMed
    1. COVID-19 Data Repository by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. https://github.com/CSSEGISandData/COVID-19. 2020 [accessed 31 July 2020].
    1. Zhou P., Yang X.L., Wang X.G., Hu B., Zhang L., Zhang W., et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–273. doi: 10.1038/s41586-020-2012-7. - DOI - PMC - PubMed