Acute kidney injury (AKI) is a severe complication of coronavirus disease (COVID-19) that negatively affects its outcome. Concern had been raised about the potential effect of renin–angiotensin–aldosterone system (RAAS) blockades on renal outcomes in COVID-19 patients. However, the association between RAAS blockade use and incident AKI in COVID-19 patients has not been fully understood. We investigated the association between RAAS blockade exposure and COVID-19-related AKI in hospitalized patients through meta-analysis. Electronic databases were searched up to 24th December 2020. Summary estimates of pooled odds ratio (OR) of COVID-19-related AKI depending on RAAS blockade exposure were obtained through random-effects model. The random-effect meta-analysis on fourteen studies (17,876 patients) showed that RAAS blockade use was significantly associated with increased risk of incident AKI in hospitalized COVID-19 patients (OR 1.68; 95% confidence interval 1.19–2.36). Additional analysis showed that the association of RAAS blockade use on COVID-19-related AKI remains significant even after stratification by drug class and AKI severity. RAAS blockade use is significantly associated with the incident AKI in hospitalized COVID-19 patients. Therefore, careful monitoring of renal complications is recommended for COVID-19 patients with recent RAAS blockade use due to the potential risk of AKI.
【저자키워드】 viral infection, Kidney diseases, 【초록키워드】 COVID-19, coronavirus disease, Meta-analysis, Stratification, severity, outcome, database, Kidney injury, AKI, Complication, RAAS, estimate, concern, patients, COVID-19 patients, association, hospitalized COVID-19 patient, Analysis, Odds ratio, COVID-19 patient, hospitalized COVID-19 patients, 95% confidence interval, increased risk, potential risk, random-effects model, blockade, renal, Affect, significantly, investigated, raised, searched, hospitalized patient, 【제목키워드】 coronavirus disease, Meta-analysis, systematic review, risk, Acute kidney injury, Patient, blockade, Increased,