Acute Kidney Injury And Renal Replacement Therapy In COVID-19 Patients

Objective:Reported rates of acute kidney injury(AKI)have varied significantly among studies of coronavirus disease 2019(COVID-19).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 from 01 December2019 to 25 July 2020.Pooled analyses were conducted using R and Stata.Results:58 studies of 22671 hospitalized patients were included in the present meta-analysis.The pooled incidence of AKI in 51 studies including 21531 patients was 12.3%(95%CI 9.5–15.6%),with higher rates of 38.9% in 290 kidney transplant patients(95%CI 27.3–51.9%),39.0% in 626 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 17664 patients,with an overall pooled use of 5.4%(95%CI 4.0–7.1%),with higher rates of 15.6% in 117 kidney transplant patients(95%CI 9.9–23.8%)and 16.3% in 776 ICU patients(95%CI 11.1–23.3%).The pooled incidence of mortality in 12 studies including 1916 AKI patients was 78.8%(95%CI 61.0–89.9%).According to our meta-regression,age,sex,hypertension,diabetes,cardiovascular disease and chronic obstructive pulmonary diseases were associated with AKI occurrence in hospitalized COVID-19 patients.Conclusion:AKI is a common complication in hospitalized COVID-19 patients with higher rates in kidney transplant and ICU patients.The incidence of AKI is 12.3% and RRT use is 5.4% in COVID-19 patients,which need to be paid more attentions for clinicians.