Objective To analyse the incidence, risk factors and impact of acute kidney injury (AKI) on the prognosis of patients with COVID-19.
Data sources PubMed, Embase, CNKI and MedRxiv of Systematic Reviews from 1 January 2020 to 15 May 2020.
Study selection Studies examining the following demographics and outcomes were included: patients’ age; sex; incidence of and risk factors for AKI and their impact on prognosis; COVID-19 disease type and incidence of continuous renal replacement therapy (CRRT) administration during COVID-19 infection.
Results A total of 79 research articles, including 49 692 patients with COVID-19, met the systemic evaluation criteria. The mortality rate and incidence of AKI in patients with COVID-19 in China were significantly lower than those in patients with COVID-19 outside China. A significantly higher proportion of patients with COVID-19 from North America were aged ≥65 years and also developed AKI. European patients with COVID-19 had significantly higher mortality and a higher CRRT rate than patients from other regions. Further analysis of the risk factors for COVID-19 combined with AKI showed that age ≥60 years and severe COVID-19 were independent risk factors for AKI, with an OR of 3.53, 95% CI (2.92–4.25) and an OR of 6.07, 95% CI (2.53–14.58), respectively. The CRRT rate in patients with severe COVID-19 was significantly higher than in patients with non-severe COVID-19, with an OR of 6.60, 95% CI (2.83–15.39). The risk of death in patients with COVID-19 and AKI was significantly increased, with an OR of 11.05, 95% CI (9.13–13.36).
Conclusion AKI was a common and serious complication of COVID-19. Older age and having severe COVID-19 were independent risk factors for AKI. The risk of in-hospital death was significantly increased in patients with COVID-19 complicated by AKI.
- kidney & urinary tract disorders
- acute renal failure
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Contributors JR and LL conceived the study, performed literature searches, extracted the data, assessed the quality of the studies and drafted the manuscript. XW and RJW performed literature searches. YS and KL performed the statistical analysis and drafted the manuscript. JY and LZ drafted the manuscript. All authors read and approved the final manuscript.
Funding This work was supported by the Basic and Frontier Research ProgramProgramme of Chongqing (cstc2017jcyjBX0014, cstc2019jscx-msxmX0166) and grants from the National Natural Science Foundation of China (81770682).
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplemental information. All data are inside the paper.
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